Weekly Chest CasesArchive of Old Cases

Case No : 1451 Date 2025-08-11

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  • Courtesy of Ji Young Lee, Eui Jin Hwang / Seoul National University Hospital
  • Age/Sex 42 / F
  • Chief ComplaintDyspnea and cough for 2 months
  • Figure 1
  • Figure 2
  • Figure 3

Diagnosis With Brief Discussion

Diagnosis
Pulmonary artery sarcoma
Radiologic Findings
Fig 1. Plain chest radiography show mild bulging opacity at right hilum, with borderline cardiomegaly.
Fig 2-3. Contrast-enhanced chest CT images show extensive filling defect in pulmonary trunk and bilateral main pulmonary arteries. Internal calcifications are noted in the filling defect.
Brief Review
Pulmonary artery sarcoma is an extremely rare malignancy arising from the intimal layer of the pulmonary artery. Common symptoms include dyspnea, cough, hemoptysis, and weight loss. Pulmonary artery sarcoma frequently misdiagnosed as chronic pulmonary thromboembolism. CT and PET-CT are useful tools for the diagnosis. Contrast-enhanced CT can show eccentric filling defects or complete occlusion of proximal pulmonary arteries. The expansion of involved arteries and extraluminal extension of tumor can be observed. FDG-PET may be useful in differentiating pulmonary thromboembolism and pulmonary artery sarcoma, since bland thrombi do not uptake FDG, while pulmonary artery sarcoma show FDG uptake. Metastasis can occur in the lung and other organs. Usually, the prognosis of pulmonary artery sarcoma is poor. Surgical resection of tumor can reduce clinical symptoms and improves the survival of patients.
References
1. Chong S, Kim T, Kim B et al. Pulmonary artery sarcoma mimicking Pulmonary thromboembolism: Integrated FDG PET/CT. AJR Am J Roentgenol 2007;188(6):1691-1693.
2. Ito K, Kubota K, Morooka M et al. Diagnostic usefulness of 18F0FDG PET/CT in the differentiation of pulmonary artery sarcoma and pulmonary embolism. Ann Nucl Med. 2009;23(7):671-676.
Keywords

No. of Applicants : 71

▶ Correct Answer : 67/71,  94.4%
  • - Funabashi General Hospital , Japan MANABU AKIMOTO
  • - Saitama-Sekishinkai Hosptal , Japan MIHOKO YAMAZAKI
  • - , Japan SUZUNE TSUKAMOTO
  • - medical scanning , Japan HIROAKI ARAKAWA
  • - IUHW Narita Hospital , Japan ISSEI FUKUDA
  • - ZIGONG TCM HOSPITAL OF CHINA , China CAO CUN YOU
  • - Shiga University of Medical Science , Japan AKITOSHI INOUE
  • - Kyoto University , Japan AKIHIKO SAKATA
  • - Affilitated Hospital of Jining Medical college , China JIANG SHENG HUA
  • - McGill University Health Center , Canada ALEXANDRE SEMIONOV
  • - Oita university , Japan AYUMI KAMEI
  • - Kyoto City Hospital , Japan YUSUKE UTSUNOMIYA
  • - Inje University Haeundae Paik Hospital , Korea (South) HYUNGIN PARK
  • - , Korea (South) DONG-HO BANG
  • - , Italy PAOLO BALDASSARI
  • - Teikyo University Hospital , Japan CHIAKI SATO
  • - Chonbuk National University Hospital , Korea (South) EUNCHONG LEE
  • - , Senegal AXEL MBUYU KAYEMBE
  • - , Korea (South) JIN YOUNG LEE
  • - , China FANG YING GEN
  • - Secomedic Hospital , Japan FUMINORI MIYOSHI
  • - Oita University, Faculty of Medicine , Japan FUMITO OKADA
  • - Seoul Medical Center , Korea (South) HYUK GI HONG
  • - , Korea (South) KANGHWI LEE
  • - university of montreal , Canada Andrei Bogdan Gorgos I
  • - QATIF CENTRAL HOSPITAL , Saudi Arabia HANI M ALSALAM
  • - University of Yamanashi , Japan TAKAAKI HASHIMOTO
  • - Osaka University , Japan AKINORI HATA
  • - University of Yamanashi , Japan HIROYUKI MORISAKA
  • - Shimada General Medical Center , Japan HAYATO NOZAWA
  • - The University of Tokyo Hospital , Japan TOSHIHIRO FURUTA
  • - , Japan YOSHIKI ISHII
  • - University of Yamanashi , Japan HIROAKI WATANABE
  • - Narayana Multispeciality Hospital Jaipur Rajasthan , India JAINENDRA JAIN
  • - Yonsei University,Severance Hospital , Korea (South) JUN GU KANG
  • - Seoul National University Bundang Hospital , Korea (South) JOONHYUK LEE
  • - Other , Korea (South) CHAEHUN LIM
  • - Osaka Metropolitan University Hospital , Japan SHU MATSUSHITA
  • - , Japan SHUNJIRO NOGUCHI
  • - , Japan MARINO TANIGUCHI
  • - Jichi Medical University, School of Medicine , Japan MITSURU MATSUKI
  • - , Japan MASAMICHI IWAI
  • - University of Tsukuba, Dept of Radiology , Japan MANABU MINAMI
  • - Shiga General Hospital , Japan YUSAKU MORIBATA
  • - Avrasya Hospital/ISTANBUL , Turkey MURAT ULUSOY
  • - Osaka metropolitan university Hospital , Japan TATSUSHI OURA
  • - Dokkyo Medical University , Japan HIROAKI ARAKAWA
  • - Other , Korea (South) SEOL A LEE
  • - Korea University Anam Hospital , Korea (South) KYU-CHONG LEE
  • - , Japan MATSUNO MAI
  • - Kyoto University , Japan SHO KOYASU
  • - Kobe Children , Japan SHUHEI NORIMOTO
  • - Seoul National University Bundang Hospital , Korea (South) YOONAH DO
  • - Kyung Hee University Medical Hospital , Korea (South) JEONG TAEK YOON
  • - CHA University, CHA Bundang Medical Center , Korea (South) HWANGSEON JU
  • - Yonsei University,Severance Hospital , Korea (South) SEO BUM CHO
  • - Fukuoka university , Japan KEISUKE SATO
  • - Kantou Rousai Hospital , Japan KAORU SUMIDA
  • - Ehime University , Japan TOMOHISA OKADA
  • - , Japan YUMI MAEHARA
  • - Toyota Kosei Hospital , Japan YUKI HAYASHI
  • - Chonbuk National University Hospital , Korea (South) HYEONG RYUN CHO
  • - The Catholic University of Korea Yoeuido St. Mary , Korea (South) CHAWOONG JEON
  • - the first affiliatited hospital of nanjing medical univercity , China HAI XU
  • - University of Yamanashi , Japan KOJIRO ONOHARA
  • - , Japan JUN YOSHIDA
  • - Jiangsu province hospital , China WANGJIAN ZHA
▶ Correct Answer as Differential Diagnosis : 3/71,  4.2%
  • - Healthy Longevity Medical Center , Japan SHIN-ICHI CHO
  • - Shiga University of Medical Science , Japan RYO UEMURA
  • - Nara medical university , Japan HIROHIDE WATANABE
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Each Case of This Site Supplied by the Members of KSTR.
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Current Editor : Eui Jin Hwang, M.D., Ph.D Email : weeklychestcases@gmail.com

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