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Pulmonary artery angiosarcoma: a clinicopathologic and radiological correlation.

Lei Huo¹, Syeling Lai, Gregory Gladish

¹Department of Pathology, The University of Texas M. D. Anderson Cancer Center, Houston, TX 77030-4009, USA.

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Summary

A rare malignant spindle and epithelioid tumor obstructing the pulmonary artery was surgically removed. This case highlights a challenging diagnosis and successful surgical intervention for pulmonary artery tumors.

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Area of Science:

Cardiovascular Pathology
Thoracic Oncology
Surgical Pathology

Background:

Pulmonary artery tumors are rare, often presenting with nonspecific symptoms like cough and dyspnea.
Malignant tumors of the pulmonary artery require prompt diagnosis and management to prevent life-threatening complications.

Observation:

A 69-year-old male presented with respiratory symptoms, initially misdiagnosed.
Radiological imaging revealed a tumor mass occluding the right pulmonary artery and involving the pulmonary trunk.
Histopathological examination showed a malignant spindle and epithelioid tumor with osteosarcomatous differentiation.

Findings:

Immunohistochemistry revealed tumor cells positive for CD31 and vimentin, and negative for pan-cytokeratin, CD34, and S100.
The tumor exhibited features of malignancy, including necrosis and high mitotic activity.
Vascular channel formation was noted in some areas of the tumor.

Implications:

This case underscores the importance of considering rare tumors in the differential diagnosis of pulmonary artery obstruction.
Successful surgical resection (right pneumonectomy) led to a positive outcome for the patient.
Further research into the immunohistochemical profile and behavior of such rare pulmonary artery neoplasms is warranted.