Fig. 3

An over-reading (type 1) error with a positive effect on patient management. When evaluating contrast-enhanced CTs, failure to adjust the window settings may cause calcified lesions to be confused with vascular lesions (blue arrows, a, b). A 67-year-old female patient presented with the complaint of hemoptysis to another hospital. Before that admission, she had been investigated several times for hemoptysis in different medical centers via CTA, which had shown no apparent causes and no dilated bronchial artery. The patient had been discharged each time because of negative imaging findings and regression of symptoms. Upon this last admission, pulmonary CTA was performed and reported as «Consistent with pulmonary artery aneurysm in the right lung apex.». The patient was referred urgently to our vascular interventional unit. Invasive pulmonary angiography revealed nothing abnormal (d). It was later understood that a calcified nodule at the right apex (blue arrow, c) caused the over-reading error by mimicking an aneurysm. It was decided to perform bronchial arteriography following pulmonary angiography while the patient was already in the operating room because of the long-term recurrent hemoptysis history. Dilated, distorted and tortuous bronchial vessels detected on bronchial arteriography (red arrow, e) were embolized. Throughout a one-year follow-up period, the patient had no recurrence of hemoptysis. As shown in this case, errors do not always cause patient harm. Occasionally, an error may have a positive effect on patient management. The diagnosis and treatment process of the underlying cause of the patient’s recurrent hemoptysis was accelerated owing to an over-reading error causing an urgent referral to our angiography unit