Zhiyue Liu, Lili Fan, Shichu Liang, Zhong Wu, He Huang
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引用次数: 0
摘要
原发性肺动脉肉瘤(PAS)是一种极为罕见的恶性肿瘤,预后较差。原发性肺动脉肉瘤的临床表现多种多样,包括呼吸困难、胸痛、咳嗽和咯血。预后不良通常是由于影像学检查结果与肺血栓栓塞症(PTE)相似而导致诊断延迟。这些诊断线索包括 "壁黯征"、分叶状隆起边缘、核磁共振成像中的钆增强以及 PET/CT 成像中的 FDG 摄取。然而,仍有许多误诊。本文报告了一名育龄妇女出现肺动脉肿块的病例。计算机断层扫描肺血管造影和正电子发射断层扫描/计算机断层扫描未显示肺动脉肉瘤的明显体征,但对比增强超声心动图显示中度灌注,有助于区分肺动脉肉瘤和肺动脉血栓形成,从而及时进行了手术治疗。肺动脉肉瘤是一种罕见的癌症,在放射影像上偶尔会与肺动脉血栓形成在视觉上相似。早期诊断 PAS 对患者的预后至关重要。有几种视觉线索可以帮助区分这两种情况。此外,对比增强超声心动图可提供肿瘤灌注的额外信息,为及时准确诊断提供了另一种有效方法。
A primary pulmonary artery sarcoma masquerading pulmonary embolism: a case report and literature review
Primary pulmonary artery sarcoma (PAS) is an extremely rare malignant tumor with a poor prognosis. The clinical manifestations of PAS are diverse, including dyspnea, chest pain, cough, and hemoptysis. The poor prognosis is often due to delayed diagnosis caused by similarity in imaging findings with pulmonary thromboembolism (PTE). These cues of diagnosis include the “wall eclipsing sign”, lobulated bulging margins, gadolinium enhancement during MRI imaging, and FDG uptake during PET/CT imaging. However, there are still many misdiagnoses. This article reports a woman of reproductive age presenting with a pulmonary artery mass. The computed tomographic pulmonary angiography and positron emission tomography/computed tomography did not show obvious signs of pulmonary artery sarcoma, however, contrast-enhanced echocardiography showed moderate perfusion, which helped differentiate between pulmonary artery sarcoma and pulmonary artery thrombosis, leading to timely surgical treatment. PAS is a rare form of cancer that can occasionally be visually similar to PTE on radiographic images. Early diagnosis of PAS is of vital importance to the prognosis of the patients. There are several visual cues that can help differentiate between the two conditions. Additionally, contrast-enhanced echocardiography provides additional information on tumor perfusion, offering another effective approach for a prompt and accurate diagnosis.
期刊介绍:
Thrombosis Journal is an open-access journal that publishes original articles on aspects of clinical and basic research, new methodology, case reports and reviews in the areas of thrombosis.
Topics of particular interest include the diagnosis of arterial and venous thrombosis, new antithrombotic treatments, new developments in the understanding, diagnosis and treatments of atherosclerotic vessel disease, relations between haemostasis and vascular disease, hypertension, diabetes, immunology and obesity.