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We report two cases of bilateral racemose hemangioma in patients with hemoptysis. Case 1 was a 62-year-old woman who visited a local clinic complaining of hemoptysis. Bronchoscopy revealed multiple pulsating tumorous lesions and she was referred to our department. Chest Multidetector CT (MDCT) disclosed bilateral enlarged and convoluted, abnormal bronchial arteries and primary racemose hemangioma was diagnosed. Bronchial artery embolization was selected, but not conducted because of concern regarding the arteriovenous shunt and escape into the greater circulation. In combination with thoracoscopic mini-thoracotomy, ligation and separation of the bronchial artery were performed. Case 2 was a 68-year-old man who was transferred to our department with a chief complaint of hemoptysis. MDCT revealed bilateral bronchiectasis and a convoluted and enlarged, abnormal bronchial artery along the mediastinum. He was diagnosed as having secondary racemose hemangioma. First, bronchial artery embolization was conducted, but hemostasis was difficult, thus surgical ligation was conducted. In both cases, MDCT was effective for diagnosis and surgical ligation is very important as a therapeutic option for racemose hemangioma.

We examined the relationship between the thoracic cross-sectional area (TCSA) and pulmonary function data or dyspnea grade in 24 patients with chronic obstructive pulmonary disease (COPD). The TCSA, i.e., the area surrounded by the rib cage, was measured on computed tomography (CT) images made 1 cm below the top of the aortic arch. Analysis of our data showed a good correlation between TCSA and total lung capacity (r = 0.65, p < 0.001), as well as functional residual capacity (r = 0.67, p < 0.0005) and residual volume (r = 0.62, p < 0.005). The patients were grouped according to their grade of dyspnea (Fletcher's five-degree scale), and the ratio of TCSA over square of height (TCSA/Ht2) was calculated for each patient. In the group with grade IV dyspnea, the TCSA/Ht2 ratios were significantly greater than those in the groups with grade II and III dyspnea, combined. In summary, in the patients with COPD, pulmonary function data indicative of lung hyperinflation correlated with the TCSA, and both parameters were increased in patients with severe dyspnea.