Theile A
Institut für Pathologie an den Berufsgenossenschaftlichen Kliniken Bergmannsheil, Universitätsklinik, Bochum.
Pathologe. 1996 May;17(3):231-4. doi: 10.1007/s002920050162.
A 74-year-old man suffered from symptoms of a left upper lobe pneumonia. Additional retrosternal masses were proved. Progression in the left upper lobe occurred in spite of antibiotic therapy; infiltrations of the right lower lobe were seen. No germs could be identified. Bronchoscopy and mediastinoscopy showed no pathological findings. His general health became worse, and the patient died under the clinical diagnosis of "wandering pneumonia" with finally suspicion of fulminant pulmonary artery embolism. Autopsy findings revealed an advanced stage of pulmonary artery sarcoma with myocardial infiltration and metastases in both kidneys and thyroid gland. General manifestation of pulmonary artery sarcoma usually are symptoms similar to those caused by pulmonary artery embolism with obstruction of pulmonary arterial flow. The unusual constellation of clinical findings similar to colliquating pneumonia results in secondary infection due to tumorous pulmonary infarction. The difficulties in diagnosis by biopsy are caused by primary intravascular growth of the neoplasms. Therefore early diagnosis in an operable tumor stage by means of CT, MR, and angiography is very important.
一名74岁男性出现左上叶肺炎症状。检查发现胸骨后有其他肿块。尽管进行了抗生素治疗，左上叶病情仍有进展；右肺下叶出现浸润。未发现病原体。支气管镜检查和纵隔镜检查未发现病理结果。患者的整体健康状况恶化，最终在“游走性肺炎”的临床诊断下死亡，最后怀疑为暴发性肺动脉栓塞。尸检结果显示为肺动脉肉瘤晚期，伴有心肌浸润以及双肾和甲状腺转移。肺动脉肉瘤的一般表现通常是类似于肺动脉栓塞导致肺动脉血流阻塞所引起的症状。与液化性肺炎相似的不寻常临床表现组合会导致肿瘤性肺梗死继发感染。活检诊断困难是由于肿瘤主要在血管内生长。因此，通过CT、MR和血管造影在可手术肿瘤阶段进行早期诊断非常重要。
