Tschirch F T C, Del Grande F, Marincek B, Huisman T A G M
Institute of Diagnostic Radiology, University Hospital Zürich, Steinwiesstrasse 75, CH-8032 Zürich, Switzerland.
Acta Radiol. 2003 Sep;44(5):504-7. doi: 10.1080/j.1600-0455.2003.00121.x.
We report on a 59-year-old male patient who suffered from dyspnea, cough and hemoptysis. Initial chest X-ray revealed a prominent right pulmonary artery (RPA) and MR imaging showed a "filling defect" within the main pulmonary trunk and RPA indicating pulmonary thromboembolic disease. Despite systemic anticoagulation, symptoms progressed. Follow-up CT showed an enlarging "filling defect" with additional extension into the left pulmonary artery as well as multiple intrapulmonary nodules. Lesion biopsy revealed a pulmonary artery angiosarcoma. Imaging findings are presented. Our case illustrates that pulmonary artery angiosarcoma should be included in the differential diagnosis of pulmonary thromboembolic disease in cases where a) symptoms do not respond to anticoagulation, b) no source of thrombi/emboli can be detected and c) pulmonary nodules/metastases develop on follow-up.
我们报告了一名59岁男性患者，他患有呼吸困难、咳嗽和咯血。最初的胸部X线检查显示右肺动脉（RPA）突出，磁共振成像显示主肺动脉和RPA内有“充盈缺损”，提示肺血栓栓塞症。尽管进行了全身抗凝治疗，症状仍进展。随访CT显示“充盈缺损”增大，并延伸至左肺动脉，同时伴有多个肺内结节。病变活检显示为肺动脉血管肉瘤。本文展示了影像学表现。我们的病例表明，在以下情况下，肺动脉血管肉瘤应纳入肺血栓栓塞症的鉴别诊断：a）症状对抗凝治疗无反应；b）未检测到血栓/栓子来源；c）随访中出现肺结节/转移灶。
