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Pulmonary Artery Sarcoma Mimicking Pulmonary Thromboembolism: Integrated FDG PET/CT

Semin Chong1, Tae Sung Kim1, Byung-Tae Kim2, Eun Yoon Cho3 and Jhingook Kim4

1 Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50, Ilwon-dong, Gangnam-gu, Seoul 135-710, Korea.
2 Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
3 Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
4 Department of Thoracic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.


Figure 1
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  		Fig. 1A —29-year-old man with pulmonary artery sarcoma. Axial contrast-enhanced chest CT image shows intraluminal filling defect in right main pulmonary artery (arrows). Small ipsilateral pleural effusion is associated with filling defect.

 

Figure 2
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  		Fig. 1B —29-year-old man with pulmonary artery sarcoma. Coronal reformation image from contrast-enhanced CT shows entire extent of filling defect from right main pulmonary artery to level of right lower lobar artery (arrows).

 

Figure 3
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  		Fig. 1C —29-year-old man with pulmonary artery sarcoma. Axial fusion image of integrated FDG PET/CT shows increased FDG uptake (maximum standardized uptake value, 7.0) in right main pulmonary artery (arrow).

 

Figure 4
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  		Fig. 1D —29-year-old man with pulmonary artery sarcoma. Coronal FDG PET image shows increased FDG uptake in right main pulmonary artery (arrows), which correlates well with areas of increased FDG uptake seen in B (i.e., coronal CT image).

 

Figure 5
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  		Fig. 1E — 29-year-old man with pulmonary artery sarcoma. Photograph of pneumonectomy specimen shows whitish-gray, myxoid, intravascular mass within right main pulmonary artery that extends to segmental branches of lower lobe pulmonary artery (arrows). Note multiple areas of subsegmental hemorrhagic infarction in right lower lobe (arrowheads).

 

Figure 6
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  		Fig. 1F — 29-year-old man with pulmonary artery sarcoma. Photomicrograph of intravascular mass shows abundant spindle cells with high cellularity, frequent mitoses, and nuclear pleomorphism; these findings are suggestive of high-grade sarcoma. (H and E, x200)

 

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