Nourdine K, Nesme P, Perol M, Douek P, De La Roche E, Bejui-Thivolet F, Loire R, Champsaur P, Guerin J C
Service de Pneumologie, Hôpital de la Croix-Rousse, Lyon.
Rev Pneumol Clin. 1996;52(6):391-7.
Sarcoma of the common pulmonary artery are rare malignant tumors which can mimic pulmonary embolism. In the case presented here, the inaugural signs were particularly misleading: multiple pulmonary lacunae on computed tomography. The unusual aspect and asymmetric localizations at pulmonary angiography then suggested the doubtful nature of the embolism etiology. Magnetic resonance imaging findings suggested the diagnosis of sarcoma of the pulmonary artery. Certain diagnosis was obtained at pathology examination of the surgical specimen after thoracotomy. A malignant fibrous histiocytoma was identified. Curative resection was not possible and chemotherapy was performed. Unusual parenchymal lesions were then evidenced on the radiography. Better and better magnetic resonance imaging criteria are described in the literature and help distinguish between thromboembolism and sarcoma of the pulmonary artery. Follow-up of the clinical course is thus improved. It is nevertheless necessary to evaluate intravascular extension to determine whether curative surgery is possible.
肺动脉肉瘤是一种罕见的恶性肿瘤，可类似肺栓塞。在此呈现的病例中，首发症状极具误导性：计算机断层扫描显示多个肺腔隙。随后，肺血管造影的异常表现和不对称定位提示栓塞病因存疑。磁共振成像结果提示肺动脉肉瘤的诊断。开胸手术后对手术标本进行病理检查得以确诊。病理诊断为恶性纤维组织细胞瘤。无法进行根治性切除，遂进行化疗。随后，影像学检查发现了异常的实质病变。文献中描述了越来越好的磁共振成像标准，有助于区分肺动脉血栓栓塞和肉瘤。从而改善了对临床病程的随访。然而，有必要评估血管内扩展情况以确定是否可行根治性手术。
