Intimal sarcoma of the right pulmonary artery: 18F-FDG PET/CT

A 54-y/o male patient presented with dyspnoea  and right-sided thoracic pain radiating to the right arm.

After exclusion of myocardial infarction, computed tomography revealed  a contrast filling defect of the right pulmonary artery as well as a suspicious paraoesophageal mediastinal mass:

The following differential diagnoses were established:

  • Primary lung cancer with mediastinal metastasis and pulmonary artery infiltration
  • Mediastinal lymph node metastasis of unkown origin and pulmonary embolism
  • Oesophageal cancer and pulmonary embolism

 

FDG-PET/CT was conducted before biopsy with the working diagnosis „primary lung cancer“.

FDG-PET/CT showed elevated glucose metabolism of the mediastinal mass as well as the tissue within the right pulmonary artery:

Biopsy revealed the rare entity of a primary angiosarcoma (intimal sarcoma) of the right pulmonary artery with mediastinal lymph node metastasis.

References:

Barmpas et al., Intimal sarcoma of the pulmonary artery, a diagnostic enigma. AME Case Rep. 2019 Aug 12;3:32. doi: 10.21037/acr.2019.07.02. PMID: 31559388; PMCID: PMC6736786.

Sharma et al., 18F-FDG PET-CT in the diagnosis of tumor thrombus: can it be differentiated from benign thrombus? Nucl Med Commun. 2011 Sep;32(9):782-8. doi: 10.1097/MNM.0b013e32834774c8. PMID: 21799368.

 

This Case was kindly provided by:

Prof. Dr. Sergios Gatidis
University Hospital of Tübingen
Department of Radiology
Hoppe-Seyler-Straße 3
72076 Tübingen

Germany
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