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Rationale: Pulmonary hemangioma is a rare thoracic condition that can lead to hemoptysis. Here we report a case that presented with lumen dilatation suggestive of bronchiectasis on high-resolution computed tomography (CT) and was misdiagnosed as bronchiectasis for more than 10 years.

Patient concerns: A 41-year-old female patient was admitted to the Department of Respiratory Medicine due to hemoptysis.

Diagnoses: The patient was misdiagnosed as having bronchiectasis for more than 10 years. Enhanced chest CT was not performed until treatment of recurrent hemoptysis with antibiotics and hemostatic therapy was no longer effective. With lumen dilation and the "signet ring" sign as the main findings on CT, pulmonary hemangiomas are easily misdiagnosed.

Interventions: A left lower lobe lobectomy was performed, and the postoperative pathology revealed a hemangioma of the left lower lobe of the lung without bronchiectasis.

Outcome: After treatment, the patient no longer had hemoptysis.

Lessons: Therefore, in the clinical diagnosis and treatment of patients presenting with hemoptysis, enhanced CT/CT angiography (CTA) is necessary for differential diagnosis.

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