Journal List > Tuberc Respir Dis > v.72(2) > 1001723

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Kim, Park, Lee, Kang, Bae, Kim, Chang, Chang, Kang, and Lee: A Case of Pulmonary Artery Intimal Sarcoma Masquerading as Pulmonary Embolism
Case Report
Tuberculosis and Respiratory Diseases

Tuberculosis and Respiratory Diseases 2012; 72(2): 218-222.

Published online: 29 February 2012

DOI: https://doi.org/10.4046/trd.2012.72.2.218

A Case of Pulmonary Artery Intimal Sarcoma Masquerading as Pulmonary Embolism

Jin Suk Kim, M.D.1, Hye Kyeong Park, M.D.1, Hye Ran Lee, M.D.1, Seung Dae Kang, M.D.1, Sang Chul Bae, M.D.1, Su Young Kim, M.D.2, Sun Hee Chang, M.D.3, Woo Ik Chang, M.D.4, Seung Hee Kang, M.D.5, Sung-Soon Lee, M.D.1

1Department of Internal Medicine, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea.

2Department of Radiology, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea.

3Department of Pathology, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea.

4Department of Cardiosurgery, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea.

5Department of Radiation Oncology, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea.

Address for correspondence: Sung-Soon Lee, M.D. Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Ilsan Paik Hospital, Inje University College of Medicine, 2240, Daehwa-dong, Ilsanseo-gu, Goyang 411-706, Korea. Phone: 82-31-910-9782, Fax: 82-31-910-7219, LeeSS@paik.ac.kr

Received 31 December 2011       Revised 18 January 2012       Accepted 6 February 2012

Copyright © 2012. The Korean Academy of Tuberculosis and Respiratory Diseases. All rights reserved.

Abstract

Pulmonary artery intimal sarcoma is a rare tumor with no characteristic symptoms. It is frequently misdiagnosed as pulmonary embolism. We report a case of pulmonary artery intimal sarcoma in a 48-year-old man with dyspnea, cough and blood-tinged sputum. He was initially suspected and treated as a pulmonary embolism. Computed tomography of the chest showed filling defects occupying the entire luminal diameter of the right and left pulmonary artery as well as extraluminal extension of the intraluminal mass. Surgical resection of the tumor confirmed pulmonary artery intimal sarcoma. After surgery, he received 8 cycles of combined chemotherapy consisting of doxorubicin and ifosfamide. After 8 cycles, Computed tomography of the chest showed interval regression of the residual tumor. Radiotherapy was done as total 6,000 cGy for 5 weeks, following the 8th chemotherapy. The patient's condition was successfully stabilized with chemotherapy and radiotherapy.

Keywords: Vascular Neoplasms, Sarcoma, Pulmonary Embolism, General Surgery, Chemotherapy, Adjuvant

Figures and Tables

Figure 1
Chest radiograph on admission showed poorly-defined multiple nodular and mass-like opacities in both lower lung fields. Dilatation of both pulmonary arterial shadows were suspected.
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Figure 2
Axial enhanced CT scans obtained with pulmonary embolism protocol showed multifocal low attenuating filling defects within the proximal left pulmonary artery (A), distal right and left pulmonary arteries, left lower lobar artery and right middle and lower lobar arteries (B, C). Main lesion was luminal expansile (arrow). Subpleural nodular consolidations were seen in the right middle lobe and left lower lobe (D). CT: computed tomography.
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Figure 3
(A~C) Axial fusion images of FDG-PET/CT showed multifocal strong FDG uptake, corresponding to the filling defects on CT scan. (D) Maximum intensity projection image of FDG-PET scan showed increased uptake of FDG in the left pulmonary hilar lesion. FDG: fluorodeoxyglucose positron; PET: emission tomography; CT: computed tomography.
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Figure 4
The anaplastic tumor cells appear storiform-patterned arrangement (H&E stain, ×200).
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