Advertisement

CardioVascular and Interventional Radiology

, Volume 17, Issue 4, pp 185–189 | Cite as

Pulmonary artery sarcoma mimicking chronic thromboembolic disease: Computed tomography and magnetic resonance imaging findings

  • Hans-Ulrich Kauczor
  • Heidi C. Schwickert
  • Eckard Mayer
  • Wilhelm Kersjes
  • Roland Moll
  • Franz Schweden
Clinical Investigation

Abstract

Purpose

The diagnosis of the rare primary malignant tumors of the pulmonary arteries is often delayed as symptoms are nonspecific.

Methods

Computed tomography (CT) and magnetic resonance imaging (MRI) of three patients with occlusion of the right pulmonary artery, two with sarcoma and one with chronic thromboembolic disease were analyzed for discriminating diagnostic criteria.

Results

Criteria suggesting pulmonary artery sarcoma are inhomogeneous high or low attenuation (hemorrhage, necrosis), soft-tissue density in pulmonary arteries, vascular distension, enhancement after administration of gadopentetate dimeglumine. Criteria for chronic thromboembolic disease are homogeneous soft-tissue lesions, abrupt vascular narrowings and cutoffs, as well as regional parenchymal hyperdensities.

Conclusion

CT and MRI provide complementary findings suggesting advanced pulmonary artery sarcoma instead of chronic thromboembolism.

Key words

Arteries, pulmonary Neoplasms Sarcoma Computed tomography Magnetic resonance imaging Embolism, chronic pulmonary 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Bleisch VR, Kraus FT (1980) Polypoid sarcoma of the pulmonary trunk: Analysis of the literature and report of a case with leptomeric organelles and ultrastructural features of rhabdomyosarcoma. Cancer 46:314–324Google Scholar
  2. 2.
    Cain H (1969) Über primäre Sarkome des Hauptstammes der Arteria pulmonalis. Dtsch Med Wschr 94:1607–1614Google Scholar
  3. 3.
    Wackers FJ, van der Schoot JB, Hampe JF (1969) Sarcoma of the pulmonary trunk associated with hemorrhagic tendency. A case report and review of the literature. Cancer 23:339–351Google Scholar
  4. 4.
    Schwickert H, Schweden F, Schild H, Düber C, Iversen S (1993) Darstellung der chronisch rezidivierenden Lungenembolie mit der Spiral-CT. Fortschr Röntgenstr 158:308–313Google Scholar
  5. 5.
    Moffat RE, Chang CH, Slaven JE (1972) Roentgen considerations in primary pulmonary artery sarcoma. Radiology 104:283–288Google Scholar
  6. 6.
    McConnell TH (1970) Bony and cartilaginous tumors of the heart and great vessels. Cancer 25:611–617Google Scholar
  7. 7.
    Shmookler BM, Marsh HB, Roberts WC (1977) Primary sarcoma of the pulmonary trunk and/or right or left pulmonary artery—a rare cause of obstruction to the right ventricular outflow. Report on two patients and analysis of 35 previously described patients. Am J Med 63:263–272Google Scholar
  8. 8.
    Daily PO, Dembitsky WM, Iversen S (1989) Technique of pulmonary thromboendarterectomy for chronic pulmonary embolism. J Cardiovasc Surg (Torino) 4:10–24Google Scholar
  9. 9.
    Krüger I, Borowski A, de Vivie ER, Theissen P, Gross-Fengels W (1990) Symptoms, diagnosis, and therapy of primary sarcomas of the pulmonary artery. Thorac Cardiovasc Surg 38:91–95Google Scholar
  10. 10.
    Smith WS, Lesar MS, Travis WD, Lubbers P, Sen RP, Ginsberg AM, DeLaney T, Lack EE, Gomes MN (1989) MR and CT findings in pulmonary sarcoma. J Comput Assist Tomogr 13:906–909Google Scholar
  11. 11.
    Remy-Jardin M, Remy J, Wattinne L, Giraud F (1992) Central pulmonary thromboembolism: Diagnosis with spiral volumetric CT with a single-breath-hold technique-comparison with pulmonary angiography. Radiology 185:381–387Google Scholar
  12. 12.
    Delany SG, Doyle TCA, Bunton RW, Hung NA, Joblin LU, Taylor DR (1993) Pulmonary artery sarcoma mimicking pulmonary embolism. Chest 103:1631–1633Google Scholar
  13. 13.
    Jacques JE, Barclay R (1960) The solid sarcomatous pulmonary artery. Br J Dis Chest 54:217–220Google Scholar
  14. 14.
    Fitzgerald PM (1983) Primary sarcoma of the pulmonary trunk: CT findings. J Comput Assist Tomogr 7:521–523Google Scholar
  15. 15.
    Weinreb JC, Davis SD, Berkmen YM, Isom W, Naidich DP (1990) Pulmonary artery sarcoma: Evaluation using Gd-DTPA. J Comput Assist Tomogr 14:647–649Google Scholar
  16. 16.
    Kösling S, Schulz H-G, Steindorf J, Weidenbach H (1993) Pleomorphes Rhabdomyosarkom des Herzens mit ungewöhnlicher Ausbreitung. Fortschr Röntgenstr 158:180–182Google Scholar
  17. 17.
    Fisher MR, Higgins CB (1986) Central thrombi in pulmonary arterial hypertension detected by MR imaging. Radiology 158:223–226Google Scholar
  18. 18.
    Tack D, Gevenois PA, Van Sinoy ML, de Francquen P, Rocmans P, Struyven J (1990) NMR-Beurteilung neoplastischer Pulmonalarterien-Invasionen. Fortschr Röntgenstr 152:23–29Google Scholar
  19. 19.
    Bressler EL, Nelson JM (1992) Primary pulmonary artery sarcoma: Diagnosis with CT, MR imaging, and transthoracic needle biopsy. AJR 159:702–704Google Scholar
  20. 20.
    Gefter WB, Hatabu H (1993) Evaluation of pulmonary vascular anatomy and blood flow by magnetic resonance. J Thorac Imaging 8:122–136Google Scholar

Copyright information

© Springer-Verlag New York Inc 1994

Authors and Affiliations

  • Hans-Ulrich Kauczor
    • 1
  • Heidi C. Schwickert
    • 1
  • Eckard Mayer
    • 2
  • Wilhelm Kersjes
    • 1
  • Roland Moll
    • 3
  • Franz Schweden
    • 1
  1. 1.Klinik mit Poliklinik für Radiologie, Universität MainzMainzGermany
  2. 2.Klinik und Poliklinik für Herz-, Thorax- und Gefäßchirurgie, Universität MainzMainzGermany
  3. 3.Institut für Pathologie, Universität MainzMainzGermany

Personalised recommendations