Xin Pu, Presenter: Nothing to Disclose

Xiaoyong Huang, Abstract Co-Author: Nothing to Disclose

Biao Lu MD, Abstract Co-Author: Nothing to Disclose

Zhanming Fan, Abstract Co-Author: Nothing to Disclose

To summarize the clinical and  imaging characteristics of pulmonary artery sarcoma (PAS).

Nine patients with PAS were enrolled during November 2001 to November 2012 in our hospital. The patients’data of clinical manifestation, lab test and  imaging findings were analyzed retrospectively.  All patients were confirmed by surgical biopsy. 

The median age of PAS patients was 43 years old (32～67y). The clinical symptoms were unspecific, including chest distress, chest pain or syncope. The D-Dimer was normal in seven patients. LDH was elevated in six patients. Seven patients were misdiagnosed as a pulmonary embolism, and were treated with failed thrombolytic therapy. Nine patients underwent pulmonary CT angiography. Pulmonary cavity filling defects were detected in eight patients, and lobulated filling defects were bulged outward with sharp edges.One patient was found the filling defect growth along the vessel wall. The main pulmonary artery and bilateral pulmonary arteries all involved were found in six patients, and two of them were found the right pulmonary arteries occluded by the lesions. Only right pulmonary artery involved was found in one patient. Bilateral pulmonary arteries involved were in two patients. The lesions were contrast enhanced heterogeneously in all 9 patients. Metastases were detected in three patients.

PAS is a rare disease that can be presented in various clinical symptoms. Pulmonary CT angiography is an important modality to find PAS. In summary, a patient with a normal D-Dimer and ineffective anticoagulation therapy, even pre-diagnosed as pulmonary embolism ,PAS should be suspected. Especially PAS should be heightened if the occupied lesion is a lobulated filling defect and obviously non-homogeneous enhanced in pulmonary CT angiography.

Pulmonary CT Angiography is very important in the diagnose of pulmonary artery sarcoma, especially in the differential diagnosis of the PAS and Pulmonary embolism. 

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Pu, X, Huang, X, Lu, B, Fan, Z, Comprehensive Clinical and  Imaging Analysis in Pulmonary Artery Sarcoma.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14006993.html