Shingaki Masami, Kobayashi Yutaka
Department of Cardiovascular Surgery, Uji-Tokushukai Hospital, Uji, Japan.
Kyobu Geka. 2014 Jul;67(7):575-7.
60-year-old female who complained of severe dyspnea was admitted with a diagnosis of massive pulmonary embolism. An emergency operation was undertaken due to right side heart failure. Under extracorporeal circulation with beating heart, large, white and smooth surface mass which was originated from right pulmonary artery was removed. Pathology of the mass showed low differentiated sarcoma. No evidence of other primary lesion by positron emission tomography-computed tomography (PET-CT) suggested primary pulmonary artery sarcoma. We scheduled total resection of the right lung, however postoperative CT showed large mass occupying from right pulmonary artery to main pulmonary trunk. Palliative chemo radiation therapy was introduced. Pulmonary artery sarcoma mimicking pulmonary thromboembolism is so malignant that the diagnosis and treatment should not be delayed.
一名60岁女性因严重呼吸困难入院,诊断为大面积肺栓塞。因右侧心力衰竭进行了急诊手术。在心脏跳动下进行体外循环,切除了起源于右肺动脉的大的、表面白色光滑的肿块。肿块病理显示为低分化肉瘤。正电子发射断层扫描-计算机断层扫描(PET-CT)未发现其他原发灶证据,提示为原发性肺动脉肉瘤。我们计划行右肺全切除术,但术后CT显示有大肿块占据从右肺动脉到主肺动脉干的区域。于是采用了姑息性化疗放疗。模仿肺血栓栓塞的肺动脉肉瘤恶性程度很高,诊断和治疗不应延误。