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An X-ray film of the thorax in a 76-year-old man with recurrent dyspnoea and haemoptysis showed a widened upper mediastinum. Computed tomography demonstrated an aneurysm of an aberrant right subclavian artery as the cause of the symptoms and the mediastinal widening. The patient died 5 days after hospitalization and before a planned operation, another episode of severe haemoptysis having been followed by haematemesis. Autopsy revealed a 13 cm-long aneurysm which had ruptured into the right upper lobe of the lung with bleeding into the bronchial system. No further cases of an aneurysm of an aberrant right subclavian artery with ruptures into the lung parenchyma have been reported so far. But it should be included as a rare cause in the differential diagnosis of recurrent haemoptysis.