Intraluminal Arterial Filling Defects Misdiagnosed as Pulmonary Emboli

Rudkovskaia, Anastasiia; Bandyopadhyay, Debabrata

doi:10.1016/j.ccm.2018.04.004

Cited by 9 publications

(10 citation statements)

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“…Transesophageal echocardiography (TEE) is more advantageous than TTE in identifying whether there is sessile tumor, the capsule is intact, the internal echo is homogeneous, there is blood supply inside, and there is filling defect of pulmonary artery or not[ 8 ]. Although intracardiac or pulmonary thrombosis, which is missed by TTE, can be detected through TEE in about 80% of patients with PTE[ 9 ], the thrombus volume was smaller than that of PAS malignant tumor.…”

Section: Discussionmentioning

confidence: 99%

Undifferentiated intimal sarcoma of the pulmonary artery: A case report

Li¹,

Liang²,

Huo³

2021

WJCC

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BACKGROUND Since 1923, only a few hundred cases of pulmonary arterial sarcoma (PAS) have been reported. It is easy for PAS to be misdiagnosed as pulmonary thromboembolism, which makes treatment difficult. The median survival time without surgical treatment for PAS is only 1.5-3 mo. Echocardiography is widely used in screening for pulmonary artery space-occupying lesions in patients with chest pain, dyspnea, and cough; furthermore, it is typically considered the first imaging examination for patients with PAS. CASE SUMMARY In May 2017, a 39-year-old male patient experienced chest pain with no particular obvious cause. At that time, the cause was thought to be pulmonary embolism. In July 2017, positron emission tomography–computed tomography revealed space-occupying lesions in the right lung and multiple metastases in both lungs. The lesions of the right lung were biopsied, and pathology revealed undifferentiated sarcoma. Chemotherapy had been performed since July 2017 in another hospital. In December 2019, the patient was admitted to our hospital for the sake of CyberKnife treatment. Echocardiography suggested: (1) A right ventricular outflow tract (RVOT) solid mass of the main pulmonary artery; and (2) mild pulmonary valve regurgitation. Ultrasonography showed the absence of a thrombus in the deep veins of either lower limb. CONCLUSION PAS is a single, central space-occupying lesion involving the RVOT and pulmonary valve. Echocardiography of PAS has its own characteristics.

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Section: Discussionmentioning

confidence: 99%

Undifferentiated intimal sarcoma of the pulmonary artery: A case report

Li¹,

Liang²,

Huo³

2021

WJCC

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Section: Nonthrombotic Pulmonary Embolismmentioning

confidence: 99%

“…Moreover, other iatrogenic embolism in high attenuation in the pulmonary arteries, such as prostate seeds, IVC filter legs, catheter fragments, CardioMEMS devices, and embolization material from a neuro procedure also have been reported. 18,19 Primary pulmonary arterial neoplasm Primary pulmonary arterial neoplasms are very uncommon. The majority are pulmonary artery sarcoma (PAS) with a poor prognosis.…”

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confidence: 99%

“…Pulmonary arterial cement embolism (PACE) is one of the inorganic particulate embolism, which occurs due to embolization into the bloodstream of polymethyl-methacrylate (cement) during surgical procedures like vertebroplasty or kyphoplasty. [18][19][20] High focal pressure may facilitate the entry of cement into the venous system, but the occurrence of PACE is independent of the volume of injected cement. Kim et al 20 reported an incidence of 23.0% after percutaneous vertebroplasty in patients with osteoporotic vertebral compression fractures.…”

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confidence: 99%

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The filling defect of pulmonary artery, an imaging finding what we should know

Liu¹,

Tao²,

Zhai³

et al. 2020

Pulm. circ.

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The most common cause of pulmonary artery filling defects on computed tomography pulmonary angiography or magnetic resonance imaging is pulmonary thromboembolism, but not infrequently, the presentation of this finding lacks specificity. Given that the morbidity and mortality associated with pulmonary thromboembolism is high, proper diagnosis of the condition is essential. Unusual or more rarely encountered etiologies must be considered when clinical manifestations and imaging findings are inconsistent. With this review, our purpose is to describe possible causes of pulmonary arterial filling defects. We aim to provide clinicians with a comprehensive list of differential diagnoses to facilitate a measured approach to the assessment of pulmonary arterial filling defects on computed tomography pulmonary angiography or magnetic resonance imaging.

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“…The imaging features of FM include infiltrating mediastinal soft tissue (with or without calcification), compression or obstruction of mediastinal internal structures, including PA, PV, SVC, esophagus, trachea, and cardiac vessels (Figure 2) (31). Ventilation/ perfusion (V/Q) scintigraphy often indicates the perfusion defects caused by pulmonary embolism, however, this can also occur in FM (32,33).…”

Section: Diagnosismentioning

confidence: 99%

Balloon angioplasty or stent implantation for pulmonary vein stenosis caused by fibrosing mediastinitis: a systematic review

Duan

Zhou

et al. 2019

Cardiovasc. Diagn. Ther.

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Fibrosing mediastinitis (FM) is a very rare disease, often caused by histoplasmosis capsulatum, tuberculosis, sarcoidosis, autoimmunity and other diseases, such as IgG 4-related diseases. Fibrous structures in the mediastinum compress the pulmonary artery, pulmonary vein, superior vena cava, esophagus, trachea and cardiac vessels, leading to clinical symptoms. Drug therapeutic modality for pulmonary vein stenosis (PVS) caused by FM is palliative in essence and with limited efficacy, whereas surgical treatment causes high mortality. In recent years, catheter-based treatment to FM-caused PVS has emerged as a promising therapeutic modality, however, the safety and effectiveness of this modality remain unclear. Therefore, a systematic review on the safety and efficacy of the catheter-based treatment for PVS caused by FM was performed, in the hope to shed lights on the alternative therapeutic strategy to this fatal disease.

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Intraluminal Arterial Filling Defects Misdiagnosed as Pulmonary Emboli

Cited by 9 publications

References 50 publications

Undifferentiated intimal sarcoma of the pulmonary artery: A case report

Undifferentiated intimal sarcoma of the pulmonary artery: A case report

The filling defect of pulmonary artery, an imaging finding what we should know

Balloon angioplasty or stent implantation for pulmonary vein stenosis caused by fibrosing mediastinitis: a systematic review

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