BackgroundThe objective of this study was to evaluate the imaging characteristics of pulmonary artery sarcoma (PAS) on pulmonary artery computed tomography angiography (PACTA) that can be used to differentiate between PAS and pulmonary thromboembolic diseases, including chronic thromboembolic pulmonary hypertension (CTEPH) and acute pulmonary embolism (APE).MethodsThe clinical data and imaging characteristics of 12 patients with PAS, 156 patients with CTEPH, and 426 patients with APE who were treated at Beijing Anzhen Hospital from January 2007 to August 2013 were retrospectively analyzed. All patients underwent PACTA before treatment, and the diagnoses of PAS and CTEPH were all confirmed by surgical biopsy.ResultsAll 12 PAS patients were initially misdiagnosed and received inappropriate thrombolytic and/or anticoagulant therapy before they were referred for surgical intervention. The mean time from PACTA to surgical intervention was 5.5±3.7 months (range 2–11 months). On PACTA, the PAS lesion always eclipsed the wall of the pulmonary artery before infiltrating outside the pulmonary artery, which was termed the wall eclipsing sign. This sign was observed in all PAS patients but was not observed in any CTEPH or APE patients.ConclusionsPAS is a rare neoplasm with a poor prognosis, and is easily misdiagnosed as thromboembolic disease. The wall eclipsing sign on PACTA is pathognomonic for PAS, and patients with this sign should be investigated to confirm the diagnosis and should undergo surgical intervention as soon as possible, rather than receiving thrombolytic or anticoagulant therapy.

Surgical treatment of intracardiac leiomyomatosis can result in satisfactory midterm to long-term survival and satisfactory heart function. Multiple surgical strategies should be tailored to the anatomic characteristics of the intracardiac leiomyoma. Recurrence of intracardiac leiomyomatosis after the resection procedure may result in unfavorable late result.

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What is known about this topic? Few major outbreaks of coronavirus disease 2019 have occurred in China after major nonpharmaceutical interventions and vaccines have been deployed and implemented. However, sporadic outbreaks that had high possibility to be linked to cold chain products were reported in several cities of China.. What is added by this report?In July 2020, a COVID-19 outbreak occurred in Dalian, China. The investigations of this outbreak strongly suggested that the infection source was from COVID-19 virus-contaminated packaging of frozen seafood during inbound unloading personnel contact. What are the implications for public health practice? Virus contaminated paper surfaces could maintain infectivity for at least 17-24 days at -25 ℃. Exposure to COVID-19 virus-contaminated surfaces is a potential route for introducing the virus to a susceptible population. Countries with no domestic transmission of COVID-19 should consider introducing prevention strategies for both inbound travellers and imported goods. Several measures to prevent the introduction of the virus via cold-chain goods can be implemented. INVESTIGATION AND RESULTSCOVID-19 cases were diagnosed by a local hospital in Dalian according to the Protocol for Prevention and Control of COVID-19 (Edition 6) issued by China CDC (1). In this study, a confirmed case was defined as having a throat swab that tested positive for COVID-19 virus RNA by RT-qPCR; an undiscovered infected case was defined as having a sera sample that tested positive for COVID-19 antibodies but negative for COVID-19 virus RNA. Detailed epidemiological investigation for early cases were conducted through in-person interviews for their travel history, activity, work history, and contact history starting 14 days (incubation period) before the onset of illness. Environmental samples and cold-chain product samples collected from Company K were further tested with RT-qPCR. Individuals who had contact with the China CDC Weekly Chinese Center for Disease Control and Prevention CCDC Weekly / Vol. 3 / No.

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The PTE procedure has statistically superiority over thrombolytic therapy for the proximal type of CTEPH in terms of actuarial survival; however, for the distal type of CTEPH, the PTE procedure provides no benefits with regard to actuarial survival.

Radical surgical resection provides the only chance of survival for patients with pulmonary artery sarcoma, and distal embolectomy may further extend survival for these patients.

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