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British Journal of Radiology (2006) 79, e36-e39
© 2006 British Institute of Radiology
doi: 10.1259/bjr/12749434
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Epithelioid angiosarcoma of the lung: a rare late complication of Lucite plombage

D Patsios, BM BCh, MRCP, FRCR (UK) 1 M de Perrot, MD, FRCPC 2 M-S Tsao, MD, FRCPC 3 and G Weisbrod, MD, FRCPC 1

Departments of 1Medical Imaging and 2Thoracic Surgery, University Health Network, Toronto General Hospital, 200 Elizabeth Street, Toronto, Ontario, M5G 2C4 and 3Department of Pathology, University Health Network, University of Toronto, Toronto, Ontario M5G 2M9, Canada


Figure 1
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  		Figure 1. (a) The frontal radiograph demonstrated deviation of the trachea to the left, narrowing of the lumen of the distal thoracic trachea secondary to mass effect from the right upper lung, which contained multiple air filled well defined plombage balls, some of which demonstrated an air fluid level. The collapsed right upper lobe demonstrated soft tissue opacity in between the Lucite plombage. (b) The lateral view shows bulging of the elevated right horizontal fissure and the right oblique fissure.

 

Figure 2
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  		Figure 2. (a) The CT of the thorax confirmed the presence of a soft tissue opacity (big white block arrow) between the Lucite plombage, causing mass effect at the level of the right main bronchus (small white arrow) and (b) an effaced right upper lobe bronchus (black arrow) anterior to the right bronchus intermedius, which is consequently displaced caudally.

 

Figure 3
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  		Figure 3. 16 Lucite balls, removed from the excised right upper lobe.

 

Figure 4
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  		Figure 4. (a) Tumour infiltrates the pleura and thickened fibrous tissue that encapsulated the necrotic lung parenchyma (haematoxylin and eosin, x50). (b) Tumour cells appear polygonal and epithelioid, and they infiltrate the blood vessel lumens (haematoxylin and eosin, magnification x100). (c) Immunohistochemistry show strong positive staining of tumour cells for vimentin (magnification x200). (d) Many tumour cells also show membranous staining for CD31, a marker of endothelial cells (magnification x200).

 




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