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Pulmonary haemangiosarcoma with main pulmonary artery thrombosis imitating subacute pulmonary embolism with infarction

¹ Department of Radiology, Klinikum der TU München, Ismaningerstr 22, 81675 Munich and ² Department of Cardiology, Deutsches Herzzentrum München, TU München, Lazarettstr 36, 80636 Munich, Germany

View larger version (128K): [in a new window]   Figure 1. Chest radiograph displaying a prominent pulmonary artery left retrocardiac lower lobe consolidation or mass and a right mid zone infiltrate found to be consistent with pulmonary haemorrhage on subsequent CT.

View larger version (139K): [in a new window]   Figure 2. (a) Initial pulmonary CT angiography (CTA) in the early arterial phase showing pulmonary arterial hypertension with a main pulmonary artery diameter exceeding the ascending aortic width and left pulmonary artery thrombosis with "smooth-margined" proximal total occlusion at its origin. Note right hilar subcarinal and paratracheal lymphadenopathy and the left lower lobe-consolidating mass (*), which was initially interpreted as pulmonary infarction. (b) The late subsequent late arterial CTA 1 week later shows bright tumour enhancement within the pulmonary mass (arrowheads). Axial CT section below the carina displays the main tumour portion within the left lower pulmonary lobe (arrowheads). The patient had new small bilateral pleural effusions.