Tuberc Respir Dis.  2014 Mar;76(3):136-140.

A Case of Pulmonary Artery Sarcoma Presented as Cavitary Pulmonary Lesions

• Min D
• Lee JH
• Jeong HC
• Kim JH
• Shin SP
• Kim HM
• Han KH
• Jeong HY
• Kim EK

Abstract

Pulmonary artery sarcoma (PAS) is a rare, poorly differentiated malignancy arising from the intimal layer of the pulmonary artery. Contrast-enhanced chest computed tomography (CT) is a good diagnostic modality that shows a low-attenuation filling defect of the pulmonary artery in PAS patients. An 18-year-old man was referred to our hospital for the evaluation and management of cavitary pulmonary lesions that did not respond to treatment. A contrast-enhanced CT of the chest was performed, which showed a filling defect within the right interlobar pulmonary artery. The patient underwent a curative right pneumonectomy after confirmation of PAS. Although lung parenchymal lesions of PAS are generally nonspecific, it can be presented as cavities indicate pulmonary infarcts. Clinicians must consider the possibility of PAS as well as pulmonary thromboembolism in patients with pulmonary infarcts. So, we report the case with PAS that was diagnosed during the evaluation of cavitary pulmonary lesions and reviewed the literatures.

Keyword

Pulmonary Artery; Sarcoma; Pulmonary Infarction

MeSH Terms

Adolescent
Humans
Lung
Pneumonectomy
Pulmonary Artery*
Pulmonary Embolism
Pulmonary Infarction
Sarcoma*
Thorax
Tomography, X-Ray Computed

Figure

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  Figure 1 Initial chest radiography shows patchy consolidations in the right upper lobe.

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  Figure 2 Non-enhanced chest computed tomography (CT) images. (A) Initial non-enhanced chest CT shows a 5-cm cavitary consolidation in the right upper lobe posterior segment. (B-D) Follow-up CT show changes in the pulmonary lesions, decrease in size of the main cavitary consolidation and increase in the number and size of adjacent nodular consolidations.

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  Figure 3 Contrast-enhanced chest computed tomography shows a filling defect within the lumen of the right interlobar pulmonary artery (arrows).

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  Figure 4 Positron emission tomography-computed tomography shows increased 18F-fluorodeoxyglucose uptake, with a maximum standardized uptake value of 9.6 along the right interlobar pulmonary artery (arrows).

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  Figure 5 (A) Intravascular mass. (B-D) Histopathologic examination reveals abundant spindle cells with high cellularity, frequent mitoses, and nuclear pleomorphism (B, H&E stain, ×20). Immunohistochemical staining is positive for smooth-muscle actin (C, ×20) and desmin (D, ×10).

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