Pulmonary arteriovenous fistula

A 30-year-old male patient presented with history of haemoptysis associated with cyanosis and clubbing. Chest computed tomography revealed a simple-type pulmonary arteriovenous fistula in the right middle lobe. Operative finding showed a bulging arteriovenous fistula covered with a thin layer of pleura. Right middle lobectomy was performed. He had an uneventful postoperative recovery. Bulging out of arteriovenous fistula out of lung tissue is a rarity and carries risk of rupture.