Key result
A multimodal imaging approach including CT, CT angiogram, and PET/CT, followed by tissue biopsy, successfully diagnosed a rare case of pulmonary artery intimal sarcoma with metastases.
Why the study?
Pulmonary artery intimal sarcoma is a rare tumor with nonspecific symptoms and challenging radiographic interpretations across imaging modalities.
Case Report (n=1)
Highlights the necessity of a multimodal imaging approach and tissue biopsy for the accurate diagnosis of rare pulmonary artery intimal sarcoma, which can mimic primary lung carcinoma.
PAIS may mimic lung carcinoma on CT; leaves open need for refined multimodal diagnostics in vascular lesions.
Pulmonary artery intimal sarcoma (PAIS) is a rare tumor without clear syndromic presentation other than nonspecific symptoms of cough, dyspnea, and weight loss. This diagnosis is difficult due to challenging radiographic interpretations of multiple imaging modalities. We present a case of a 60-year-old male, who presented to his pulmonologist and underwent a CT chest with IV contrast that initially suggested primary lung carcinoma. CT angiogram showed significant vascular filling defects suspicious of an intravascular mass, rather than vascular invasion by lung lesions. The PET/CT scans further suggested a malignant process, but indistinguishable between an extravascular or intravascular etiology. Taking these results together, they suggested an intravascular malignancy, prompting a tissue biopsy, which ultimately led to a diagnosis of PAIS with metastases. Establishing a definitive diagnosis is essential as treatment and prognosis are different for sarcoma compared to carcinoma. There is no standard treatment to date, and management often includes a multidisciplinary approach involving surgery, radiation, chemotherapy, and targeted therapy. PAIS is a rare entity that cannot be diagnosed clinically and needs a multimodality approach for its diagnosis.
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Nakrani et al. (2020) conducted a case report in Pulmonary artery intimal sarcoma (PAIS) (n=1). Multimodal imaging approach and tissue biopsy was evaluated on Diagnosis of PAIS. A multimodal imaging approach including CT, CT angiogram, and PET/CT, followed by tissue biopsy, successfully diagnosed a rare case of pulmonary artery intimal sarcoma with metastases.
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