Mediastinal bronchial artery aneurysm (BAA) is a rare and life-threatening disease. We experienced the first case confirming that, despite only slight deterioration of bronchiectasis, mediastinal BAAs expanded remarkably. A 61-year-old female was hospitalized because of hemoptysis. Her respiratory condition required intubated mechanical ventilation. Bronchial artery angiography unexpectedly found unruptured mediastinal BAAs. These BAAs were enlarged compared with those seen in a computed tomography (CT) taken 5 years before. We successfully embolized both BAAs and peripheral arteries. Mediastinal BAAs are capable of increasing more rapidly than a slightly deteriorated underlying bronchiectasis. For rapid and accurate diagnosis of BAA, bronchial artery angiography is important.
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