MR and CT Findings in Pulmonary Artery Sarcoma

Ws, Smith; Ms, Lesar; Wd, Travis; P, Lubbers; Rp, Sen; Am, Ginsberg; Delaney, Thomas B.; Ee, Lack; Mn, Gomes

doi:10.1097/00004728-198909000-00031

Cited by 28 publications

(7 citation statements)

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“…The appearance was consistent with myofibroblasts ( Fig. However, preoperative diagnosis by means of CT and magnetic resonance imaging has been reported (Smith et al 1989) and as distant metastasis is a rare, or a late occurring, event, PAS may be amenable to surgical invention. Immunohistochemical findings are outlined in Table 3.…”

Section: Resultsmentioning

confidence: 82%

“…The first case was reported by Mandelstam in 1923. Preoperative diagnosis by means of computed tomography (CT) and magnetic resonance imaging have been reported (Smith et al 1989), and there are reports of successful treatment with a combination of resection and homograft reconstruction (Dossche et al 1992;Head et al 1992;Okada et al 1993). In 1980 Bleisch and Kraus reported 60 cases, 28 of which were from the non-English literature.…”

Section: Introductionmentioning

confidence: 99%

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Sarcoma of the pulmonary artery: report of four cases with electron microscopic and immunohistochemical examinations, and review of the literature

Johansson

Carlén

1994

Vichows Archiv A Pathol Anat

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Herein we report the clinicopathological features of four cases of pulmonary artery sarcoma that appeared at our institution during a period of 30 years. The patients, 2 males and 2 females, were 50-62 years old. Tumour was found in the pulmonary trunk and right pulmonary artery in all cases, in the pulmonary valve and left pulmonary artery in three of the four cases, and in the right ventricular outflow tract in one case. There was direct extension or metastases to the lungs in two cases, the heart in one case, mediastinum or lymph nodes in two cases and the pleura in one case. Ultrastructural examination in one case revealed cells with features of smooth muscle cells and myofibroblasts. Immunohistochemical examination of three cases gave the following results: vimentin and smooth muscle specific actin was positive in all three cases, desmin in one case and cytokeratin in one case. No positivity was found for Factor VIII. This and other studies indicate that histologically most pulmonary artery sarcomas are leiomyosarcomas or "undifferentiated spindle cell sarcomas". Immunohistochemical and ultrastructural examinations favour an origin from myofibroblasts, probably derived from multipotent (undifferentiated) cells in the wall of the vessel. Most lesions show extensive intrathoracic growth although they rarely metastasize outside the thoracic cavity. They have a poor prognosis although some cases are currently being diagnosed during life.

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Section: Resultsmentioning

confidence: 82%

Section: Introductionmentioning

confidence: 99%

Sarcoma of the pulmonary artery: report of four cases with electron microscopic and immunohistochemical examinations, and review of the literature

Johansson

Carlén

1994

Vichows Archiv A Pathol Anat

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“…In our study, PAIS was significantly more heterogeneous and had higher attenuation than PTE. Most previous studies also have shown heterogeneous enhancement of PAS and PAIS ( 13 14 15 16 17 ), except for one study that found no significant difference in mean attenuation between PAIS and PTE ( 7 ). In the previous studies, necrosis and hemorrhage were common features of PAIS ( 1 14 18 ); in our study, intratumoral vessels were significantly more common in PAIS.…”

Section: Discussionmentioning

confidence: 95%

Pulmonary Artery Intimal Sarcoma versus Pulmonary Artery Thromboembolism: CT and Clinical Findings

Kim

Kang

et al. 2018

Korean J Radiol

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ObjectiveTo describe CT and clinical findings of pulmonary artery intimal sarcoma (PAIS) compared with those of pulmonary thromboembolism (PTE), to investigate MRI and positron emission tomography (PET)-CT findings of PAIS, and to evaluate the effect of delayed diagnosis of PAIS on survival outcomes.Materials and MethodsTwenty-six patients with PAIS were retrospectively identified and matched for sex, with patients with PTE at a ratio of 1:2. CT and clinical findings of the two groups were compared using Student's t test or chi-square test. The effect of delayed diagnosis on survival was investigated using Kaplan-Meier analysis.ResultsThe most common tumor pattern in PAIS was tumoral impaction. Heterogeneous attenuation, wall eclipse signs, intratumoral vessels, acute interphase angles, single location, presence of lung ischemia, and central location were significantly more common in PAIS than in PTE (all p < 0.01). Levels of D-dimers and brain natriuretic peptide were lower in PAIS than in PTE (p < 0.05). In three patients of PAIS, long inversion time sequence MRI showed intermingled dark signal intensity foci suggestive of intermingled thrombi. All nine patients who had undergone PET-CT displayed hypermetabolism. Diagnosis was delayed in 42.3% of the PAIS patients and those patients had a significantly shorter overall survival than patients whose diagnosis was not delayed (p < 0.05).ConclusionThe characteristic CT and clinical findings of PAIS may help achieve early diagnosis of PAIS and make better survival outcomes of patients. MRI and PET-CT can be used as second-line imaging modalities and could help distinguish PAIS from PTE and to plan clinical management.

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“…Echocardiography and pulmonary angiography is difficult to distinguish between tumor and thromboembolic diseases of the PAs. CT scanning cannot differentiate them either unless there is evidence of local invasion or metastatic disease 10‐12 . The heterogenous enhancement of an intraluminal filling defect on Gadolinium‐enhanced MRI is characteristic of a vascularized tumor 13,14 .…”

Section: Discussionmentioning

confidence: 99%

Primary Pulmonary Artery Sarcoma: Surgical Management and Differential Diagnosis with Pulmonary Embolism and Pulmonary Valve Stenosis

Liu

2009

Journal of Cardiac Surgery

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Because of similar clinical features, pulmonary artery sarcomas are often confused with other pulmonary vascular obstructive diseases. Computed tomography scanning and gadolinium-enhanced magnetic resonance imaging could be useful methods for differential diagnosis. The prognosis is very poor. The survival time after resection varies from several months to several years depending on the presence of recurrence or metastasis. Early diagnosis and radical surgical resection presents the only opportunity for a potential cure.

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MR and CT Findings in Pulmonary Artery Sarcoma

Cited by 28 publications

References 0 publications

Sarcoma of the pulmonary artery: report of four cases with electron microscopic and immunohistochemical examinations, and review of the literature

Sarcoma of the pulmonary artery: report of four cases with electron microscopic and immunohistochemical examinations, and review of the literature

Pulmonary Artery Intimal Sarcoma versus Pulmonary Artery Thromboembolism: CT and Clinical Findings

Primary Pulmonary Artery Sarcoma: Surgical Management and Differential Diagnosis with Pulmonary Embolism and Pulmonary Valve Stenosis

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