Why the study?
Pulmonary artery intimal sarcoma is an aggressive tumor often misdiagnosed as pulmonary thromboembolism, and literature on its diagnosis by EBUS-TBNA is limited.
EBUS-TBNA with rapid on-site evaluation can be an effective, minimally invasive method for diagnosing rare pulmonary artery intimal sarcomas, enabling timely preoperative management.
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May allow minimally invasive diagnosis of this rare sarcoma; hypothesis-generating and requires validation before broader adoption.
Pulmonary artery intimal sarcoma is a rare aggressive intraluminal tumor often misdiagnosed as acute or chronic pulmonary thromboembolism due to its clinical presentation and radiological findings. Thus early diagnosis is very crucial and may improve patient outcome. There is limited literature on diagnosis of pulmonary artery sarcoma by endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA). Herein, we report a case of mass-like lesion in the PA diagnosed on cytological material obtained by EBUS-TBNA with rapid on-site evaluation (ROSE). The aspirate showed pleomorphic malignant spindled cells arranged in loosely cohesive clusters. The intraluminal origin of PAIS was supported by radiographic findings. Subsequently, the patient received preoperative chemotherapy and underwent tumor resection with reconstruction. This report describes the cytomorphologic features of this rare intravascular tumor and demonstrates how limited cytological sample obtained from EBUS-TBNA with ROSE can be triaged efficiently for ancillary studies like immunohistochemistry and MDM2 amplification, thus expediting the management.
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Harbhajanka et al. (2018) studied this question.
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