Remedy Publications LLC., | http://clinicsinoncology.com/
Clinics in Oncology
2019 | Volume 4 | Article 1575 1
Pulmonary Artery Sarcoma Intimal Mimicking Embolism
Lung
OPEN ACCESS
*Correspondence:
José Aurillo Rocha, Department of
Oncology, Federal University of Ceará,
Nucleus of Oncology Studies, Brazil,
E-mail: jaurillor@hotmail.com
Received Date: 10 Jan 2019
Accepted Date: 11 Feb 2019
Published Date: 14 Feb 2019
Citation:
Alencar RF, Rodrigues FP, Rocha JA,
Fernandes Távora FR, de A. Meireles
VSM, da Silva Leao PH. Pulmonary
Artery Sarcoma Intimal Mimicking
Embolism Lung. Clin Oncol. 2019; 4:
1575.
Copyright © 2019 José Aurillo
Rocha. This is an open access
article distributed under the Creative
Commons Attribution License, which
permits unrestricted use, distribution,
and reproduction in any medium,
provided the original work is properly
cited.
Case Report
Published: 14 Feb, 2019
Case Presentation
Female patient 46 years old with no prior medical history, dyspnea initiated efforts for one year,
loss of weight and discrete episodes of isolated fever at the beginning there, bringing chest X-rays
that period without changes in the lung fields and cardiac ; being attributed to viral infections of the
upper airway and sinus disease. en sought medical attention for presenting atypical chest pain,
epigastric pain, and the electrocardiogram showed T wave inversion in anterolateral wall; Cardiac
catheterization was performed without visualization of coronary lesions. Chest X-ray of the time
without changes.
Aſter three months, the new hospital because of episodes of pre-syncope and dyspnea on
moderate and small efforts. X-ray (Figure 1) showed rectification of the pulmonary artery trunk and
spiky image contours in the leſt hilar region later. Transthoracic echocardiogram showed dilated
right heart chambers, pulmonary artery systolic pressure of 115 mmHg and pulmonary dilated
with hiperrefringente the level of the bifurcation mainly in the leſt branch, suggestive of thrombus
image. Patient was conducted as Pulmonary Embolism (PE), and inciado full anticoagulation and
subsequent workup cause to investigate. Ultrasonography of the lower limbs was negative for
thrombus. Negative rheumatologic tests.
CT angiography of the chest (Figure 2) showed macrolobulada lesion with soſt tissue
coefficient fair compromise bronchial vessels in adjacency; ipsilateral pleural involvement with
nodular formation; ground-glass opacities in the right middle lobe and image enhancement with
the intraluminal contrast to the level of the bifurcation and the leſt pulmonary artery; suggesting
thromboembolism and neoplastic lesion.
Bronchial stenosis was seen on the leſt by bronchoscopy. Transbronchial biopsy performed
(Figure 3) in the leſt upper lobe with histopathological description of undifferentiated carcinoma
with spindle cells, nuclear pleomorphism, atypical mitosis. Immunohistochemical panel showed
positive for AE1-AE3 and negative for the other markers (actin, desmin, S-100, TTF-1, bcl-2, CD45,
CD34, CK7, estrogen and progesterone receptor, CD99). Completing the diagnosis of intimal
sarcoma of the pulmonary artery mimicking pulmonary metastasis and TEP.
Before the results of histopathology and immunohistochemistry, the hypothesis was lung cancer
as a risk factor for pulmonary thromboembolism. Patient had significant worsening of dyspnea and
underwent radiation therapy in an attempt to reduce the injury causing bronchial stenosis. Patient
without conditions at the time of initiation of chemotherapy. Died due to respiratory failure and
Abstract
e intimal sarcoma of the pulmonary artery (SIAP) is a rare tumor of mesenchymal origin
that primarily affects the large glass. e first report of the disease has been described in autopsy
performed by Mandelstamm in 1923. On displays are oſten nonspecific signs and symptoms, the
materials SIAP is commonly diagnosed as TEP, but other diagnoses are recognized as arteritis and
pulmonary neoplasia pulmonar.
e disease has a poor prognosis even aſter the intervention surgery, still considered the treatment
of choice of treatment, and a few months to years.
Raul Fava Alencar
1
, Filadélfia Passos Rodrigues
1
, José Aurillo Rocha
2
*, Fábio Rocha
Fernandes Távora
3
, Victor S.M.de A. Meireles
4
and Paulo Henrique da Silva Leao
4
1
Department of Pulmonology, Messejana Hospital, Brazil
2
Department of Oncology, Clinical Pharmacology - Federal University of Ceara, Brazil
3
Department of Pathology, Messejana Hospital, Brazil
4
Messejana Hospital, Brazil