A rare case report of pulmonary artery sarcoma diagnosed and managed based on multimodal imaging

Figures

• 

• 

  Figure 1. Transthoracic echocardiography shows a mass (arrow) within the pulmonary artery (A). Computed tomographic pulmonary angiogram showing multifocal masses (arrows) in the right ventricular outflow tract, main pulmonary artery, and right pulmonary artery (B). Cardiac computed tomography revealing multiple masses (arrows) in the right ventricle, main pulmonary artery–left pulmonary artery, and right pulmonary artery (C). Cardiac cine imaging shows masses (arrow) in the right ventricular outflow tract and pulmonary artery (D). Cardiac T2-weighted double inversion-recovery sequence shows a T2-hyperintense mass (arrow) in the right ventricular outflow tract (E). Cardiac magnetic resonance imaging with late gadolinium enhancement shows intense heterogeneous late gadolinium enhancement (F).

• 

  Figure 2. Fluorine-18 fludeoxyglucose positron emission tomography/computed tomography revealing hypermetabolic lesions (intersection of two lines and black arrow) in the right ventricular outflow tract and main pulmonary artery, without distant metastases (A, B). Histopathology indicated that the tumours in the pulmonary artery and right ventricle were consistent with pulmonary artery sarcoma. Microscopically, tumour cells were spindle-shaped and arranged in a crisscross pattern. There was marked atypia, mitoses, multifocal calcification, and arterial intimal involvement. Eosin staining microscopy, magnification 10 × 20 (C). Repeat computed tomographic pulmonary angiogram identifies a recurrent right ventricular outflow tract mass (solid arrows) and multiple parenchymal nodular opacities (dashed arrow) in the upper lobe of the left lung (D).