Primary pulmonary angiosarcoma

2021 ◽  
Vol 14 (11) ◽  
pp. e244578
Author(s):  
Muhammad Kashif Rana ◽  
Owais Rahman ◽  
Aiden O’Brien
Keyword(s):  
Pulmonary Arteries ◽  
Rare Type ◽  
Pulmonary Artery Sarcoma ◽  
Pulmonary Angiogram ◽  
Primary Pulmonary Artery Sarcoma ◽  
History Of ◽  
Ct Pulmonary Angiogram ◽  
The Right ◽  
Specific Symptoms ◽  
Large Primary

Primary pulmonary angiosarcoma is a rare type of malignant vascular tumour with poor prognosis. Diagnosis is often late due to non-specific symptoms and low clinical suspicion for angiosarcoma. A 72-year-old man presented to hospital with a 6-month history of mild progressive dyspnoea, with associated cough, episodes of presyncope and weight loss. CT pulmonary angiogram (CTPA) was reported as a large saddle pulmonary embolism extending into both the right and left pulmonary arteries. Further Multidisciplinary team meeting (MDM) discussion, and review of CTPA and subsequent investigations revealed a large primary pulmonary artery sarcoma which was later confirmed histology. The patient was referred to the cardiothoracic surgeons and underwent left radical pneumonectomy.

scholarly journals Feasibility of Detecting Pulmonary Embolism Using Noncontrast MRI

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
C. S. Mudge ◽  
T. T. Healey ◽  
M. K. Atalay ◽  
J. A. Pezzullo
Keyword(s):  
Pulmonary Embolism ◽  
Cardiac Mri ◽  
Imaging Techniques ◽  
Pulmonary Arteries ◽  
Pulmonary Emboli ◽  
Pulmonary Angiogram ◽  
Mri Protocol ◽  
Ct Pulmonary Angiogram ◽  
Magnetic Resonance Imaging Techniques ◽  
The Right

Purpose. The purpose of this study was to evaluate the feasibility of detecting pulmonary emboli utilizing noncontrast magnetic resonance imaging techniques in patients with known pulmonary embolism. Materials and Methods. Eleven patients were enrolled in a study to evaluate right ventricular function by cardiac MRI in patients diagnosed with acute pulmonary embolism on CT pulmonary angiogram. Cardiac MRI was performed as soon as possible following pulmonary embolism detection. Two independent observers reviewed the precontrast portion of each MRI, scoring right, left, and lobar arteries as positive or negative for PE. The CTs were reviewed and interpreted in the same manner. Results. MRI was obtained on average of 40 hours after the CT. Forty-eight vessels were affected by PE on CT, 69% of which were identified on MRI. All eight pulmonary emboli located in the right or left pulmonary arteries were detected on MRI. Of the 15 pulmonary emboli that were not detected on MRI, 7 were subsegmental, 6 were segmental, and 2 were located in a branch not included in the MRI field of view. Conclusions. Most pulmonary emboli detected on CT were identified on noncontrast MRI, even though our MRI protocol was not optimized for pulmonary artery visualization.

scholarly journals Pulmonary Thromboembolism in a Child with Sickle Cell Hemoglobin D Disease in the Setting of Acute Chest Syndrome

2013 ◽  
Vol 2013 ◽  
pp. 1-3 ◽  
Author(s):  
Hazel Villanueva ◽  
Sandeepkumar Kuril ◽  
Jennifer Krajewski ◽  
Aziza Sedrak
Keyword(s):  
Pulmonary Artery ◽  
Sickle Cell ◽  
Pulmonary Thromboembolism ◽  
Acute Chest Syndrome ◽  
Standard Management ◽  
Pulmonary Angiogram ◽  
Right Pulmonary Artery ◽  
Ct Pulmonary Angiogram ◽  
Complete Thrombosis ◽  
The Right

Introduction. Sickle cell hemoglobin D disease (HbSD) is a rare variant of sickle cell disease (SCD). Incidence of pulmonary thromboembolism (PE) and deep venous thrombosis (DVT) in children with HbSD is unknown. PE and DVT are known complications of SCD in adults but have not been reported in the literature in children with HbSD.Case Report. We are reporting a case of a 12-year-old boy with HbSD with acute chest syndrome (ACS) complicated by complete thrombosis of the branch of the right pulmonary artery and multiple small pulmonary artery emboli seen on computed tomography (CT) pulmonary angiogram and thrombosis of the right brachial vein seen on Doppler ultrasound. Our patient responded to treatment with anticoagulant therapy.Conclusion. There are no cases reported in children with HbSD disease presenting as ACS with pulmonary thromboembolism. We suggest that PE should be suspected in patients presenting with ACS who do not show improvement with standard management. CT pulmonary angiogram should be utilized for early diagnosis and appropriate management as there is no current protocol for management of PE/DVT in pediatric patients with SCD.

DOUBLE AORTIC ARCH

PEDIATRICS ◽  
1949 ◽  
Vol 4 (6) ◽  
pp. 751-768
Author(s):  
HERBERT E. GRISWOLD ◽  
MAURICE D. YOUNG
Keyword(s):  
Aortic Arch ◽  
Double Aortic Arch ◽  
Rare Type ◽  
Radiographic Findings ◽  
Descending Aorta ◽  
Vascular Abnormalities ◽  
History Of ◽  
The Right ◽  
The Given ◽  
Right Descending Aorta

The anatomic nature of a double aortic arch is described. Reference is made to the history of the malformation. The clinical picture and radiographic findings described by various authors are discussed. Two cases are reported which demonstrate two types of double aortic arch, One, a relatively common type, had a large right arch with a retro-esophageal component and a left descending aorta; the second, a rare type, had a large left arch with a retro-esophageal component and a right descending aorta. Further, one was an infant who had symptoms of constriction whereas the other was an adult who had no symptoms referable to the double aortic arch. Analysis is made of these cases and 47 other cases reported in the literature. This analysis reveals that: 1. There is a striking correlation between the occurrence of symptoms and the age and duration of life, but there is no correlation between the occurrence of symptoms and the type of double aortic. 2. A double aortic arch in which both components are patent throughout is more likely to produce symptoms than a double aortic arch in which one component is partially obliterated. The process of obliteration does not appear to give rise to symptoms. 3. There is considerable variation in the relative sizes of the components of a double aortic arch. The right component is usually the larger; part of the left component may be obliterated. To date, no case has been reported of obliteration of part of a persistent right Component. 4. A double aortic arch occurs more commonly with a left descending aorta than with a right descending aorta. 5. It is unusual for a double aortic arch to be associated with a malformation of the heart. The association of a double aortic arch with other vascular abnormalities is less rare. The two principal problems raised by the demonstration of a retro-esophageal vessel are discussed. The first concerns the nature of the malformation; the second concerns the advisability of operation in the given individual.

scholarly journals Uncommon cause of chest pain in a postoperative spinal patient

2018 ◽  
pp. bcr-2018-225293
Author(s):  
Rajesh Dwivedi
Keyword(s):  
Chest Pain ◽  
Spinal Surgery ◽  
Anterior Chest Wall ◽  
Sternal Fracture ◽  
Pulmonary Angiogram ◽  
Chest Wall Trauma ◽  
History Of ◽  
Ct Pulmonary Angiogram ◽  
Chest X Ray ◽  
Sternal Fractures

An 84-year-old woman with previous spinal operations including vertebroplasty and lumbar decompressions was admitted electively under the spinal team for right-sided L4/5 decompression for worsening back pain which she undergoes using a posterior approach. Postoperatively, she develops stabbing upper central chest pain and given unremarkable chest X-ray, ECG and cardiac troponin, she undergoes a CT pulmonary angiogram which shows a fracture of the upper part of sternum but no pulmonary embolism. There is no history of recent trauma and this is deemed to be secondary to prolonged spinal surgery in the prone position in a patient with osteopenic bones. To date, we have not come across a case of spontaneous sternal fracture as a complication of spinal surgery at our regional spinal unit. Most cases of sternal fractures are secondary to blunt anterior chest wall trauma with spontaneous fractures and stress fractures being rare.

The life history of the rat lung-worm, Angiostrongylus cantonensis (Chen) (Nematoda: Metastrongylidae).

1955 ◽  
Vol 3 (1) ◽  
pp. 1 ◽  
Author(s):  
MJ Mackerras ◽  
DF Sandars
Keyword(s):  
Pulmonary Arteries ◽  
Blood Stream ◽  
The Body ◽  
Angiostrongylus Cantonensis ◽  
Intermediate Hosts ◽  
Anterior Portion ◽  
Third Stage ◽  
History Of ◽  
The Central Nervous System ◽  
The Right

Adult Angiostrongylus cantonensis live in the pulmonary arteries. Unsegmented ova are discharged into the blood stream, and lodge as emboli in the smaller vessels. First-stage larvae break through into the respiratory tract, migrate up the trachea, and eventually pass out of the body in the faeces. Slugs (Agriolimax laevis) act as intermediate hosts. Two moults occur in the slug, and third-stage larvae appear about the 17th day. The larvae remain within the two cast skins until freed in the stomach of the rat by digestion. They then pass quickly along the small intestine as far as the lower ileum, where they leave the gut and become blood-borne. They congregate in the central nervous system, and have been found there 17 hr after ingestion. The anterior portion of the cerebrum is the most favoured site, and here the third moult takes place on the sixth or seventh day and the final one between the 11th and 13th days. Young adults emerge on the surface of the brain from the 12th to 14th day, and spend the next 2 weeks in the subarachnoid space. From the 28th to 31st days they migrate to the lungs via the venous system, passing through the right side of the heart to their definitive site in the pulmonary arteries. The prepatent period in the rat usually lies between 42 and 45 days.

scholarly journals Malignant Peritoneal Mesothelioma: Clinicopathological Characteristics of Two Cases

2014 ◽  
Vol 2014 ◽  
pp. 1-3 ◽  
Author(s):  
Mustafa Cem Algın ◽  
Faik Yaylak ◽  
Zülfü Bayhan ◽  
Figen Aslan ◽  
Nilüfer Araz Bayhan
Keyword(s):  
Abdominal Pain ◽  
Asbestos Exposure ◽  
Final Diagnosis ◽  
Clinicopathological Characteristics ◽  
Clinical Findings ◽  
Peritoneal Mesothelioma ◽  
Abdominal Masses ◽  
History Of ◽  
The Right ◽  
Specific Symptoms

Introduction. Peritoneal mesothelioma is a rare tumor, presenting difficulties in diagnosis and treatment. Peritoneum is the second most common area of the mesothelioma after pleura, and even synchronous pleural and peritoneal mesotheliomas are observed in 30–45% of all cases. The diagnosis may be difficult due to lack of specific symptoms and clinical findings. In addition, a delay in the diagnosis is not rare especially in the absence of previous asbestos exposure. Here we report two cases of malignant peritoneal mesotheliomas. The diagnostic and therapeutic approaches for these rare neoplasms are discussed.Case Presentation. The cases were two men (one aged 54 years old and the other 40 years old). Prolonged abdominal pain and swelling were the primary presentation symptoms and findings. The mesotheliomas were developed in the right upper quadrant of abdomen in both of the cases. Both cases were treated with surgical resection. Final diagnosis were possible with histological and immunohistochemical documentation of tumor characteristics, which were consistent with dictating a mesothelial origin. No history of asbestos exposure was reported.Conclusion. Peritoneal mesotheliomas are rare clinical entities. However, patients with prolonged abdominal pain and abdominal masses should be considered to have atypical pathologies such as peritoneal mesotheliomas.

scholarly journals 780 Appearing and disappearing right-heart thrombus: a case reporto in COVID-19 patient

2021 ◽  
Vol 23 (Supplement_G) ◽  
Author(s):  
Giacomo Campi ◽  
Martina Finocchi ◽  
Nicolas Palagano ◽  
Emanuela Calcagno ◽  
Alessandra Pesci ◽  
...  
Keyword(s):  
Venous Thromboembolism ◽  
Right Ventricle ◽  
Thrombus Formation ◽  
Nasopharyngeal Swab ◽  
Cardiac Ultrasound ◽  
Free Wall ◽  
Pulmonary Angiogram ◽  
Right Ventricle Free Wall ◽  
Ct Pulmonary Angiogram ◽  
The Right

Abstract Aims Venous thromboembolism represents frequent complication of patients with severe COVID-19 disease. Several reports about atypical thrombosis are described, rarely it has been described a right venticular thrombus during the course of infection. We report a case of right endoventricular thrombosis in a patient with SARS-Cov-2 pneumonia. Methods and results A 58-year-old man was admitted to our ward for severe respiratory failure in interstitial pneumonia. The nasopharyngeal swab for COVID-19 resulted positive. Steroids and prophylaxis with LMWH were started, associated to CPAP to maintain good gas exchange. During hospitalization a venous ECD was performed with evidence of left popliteal thrombosis despite the therapy. d-Dimer was 4463  ng/ml. A new onset AF was documented at the telemetry, without troponin elevation. A cardiac ultrasound was performed showing a right endoventricular lesion of 1.8  cm adhering to the free wall of the right ventricle. A CT-pulmonary angiogram (CTPA) resulted negative for pulmonary embolism and confirmed suspected right ventricular thrombus. Treatment with fondaparinux 7.5 mg was started. After 10 days, cardiac ultrasound shown complete resolution of thrombosis, and CT confirmed the disappearing of the mass. Dabigatran 150  mg twice/day was started. Patient clinically improved and he was discharged after 20 days of hospitalization. Conclusions SARS-CoV-2 infection may cause inflammation with cytokine storm and hypercoagulability leading to venous thromboembolism. Atypical thrombus formation was reported, including right-ventricle free wall. Early caridac ultrasound was critical to make diagnosis and starting prompt treatment, therefore routine cardiac ultrasound is mandatory in severe COVID-19 patients.

Pulmonary mucormycosis causing a mycotic pulmonary artery aneurysm

2021 ◽  
pp. 021849232199849
Author(s):  
Richard Saldanha ◽  
Ravi Ghatanatti ◽  
Mohan D Gan ◽  
Kiran Kurkure ◽  
Gautam Suresh ◽  
...  
Keyword(s):  
Pulmonary Artery ◽  
Artery Aneurysm ◽  
High Morbidity ◽  
Pulmonary Artery Aneurysm ◽  
Pulmonary Mucormycosis ◽  
Pulmonary Angiogram ◽  
Ct Pulmonary Angiogram ◽  
Pulmonary Artery Aneurysms ◽  
The Right ◽  
Very High

Mycotic pulmonary artery aneurysms requiring pneumonectomy are extremely rare. We present a severely breathless immunocompromised diabetic middle-aged female patient. CT pulmonary angiogram revealed a giant pulmonary artery aneurysm with impending rupture in the right lung. We did an emergency right pneumonectomy under cardiopulmonary bypass support. Histopathology report of the lung specimen confirmed mucormycosis. She received amphotericin B after the procedure. The patient had a prolonged postoperative hospital stay and succumbed to sepsis. Mycotic pulmonary artery aneurysm portends very high morbidity and mortality in immunocompromised patients.

scholarly journals Primary renal leiomyosarcoma: A rare case report

2021 ◽  
pp. 503-505
Author(s):  
Sudeshna Nandi ◽  
Smritiparna Das ◽  
Chhanda Das ◽  
Madhumita Mukhopadhyay
Keyword(s):  
Abdominal Pain ◽  
Immunohistochemical Staining ◽  
Rare Case ◽  
Past History ◽  
Renal Calculi ◽  
Rare Type ◽  
The Past ◽  
Rare Case Report ◽  
History Of ◽  
The Right

Leiomyosarcoma of the kidney is a rare type of adult renal sarcoma. Here, we presented a case of a 68-year-old female who had a past history of bilateral renal calculi 3 years back with hydronephrotic changes, now presented to the OPD with complaints of abdominal pain for the past few months. On further evaluation, a heterogeneously enhancing necrotic mass was identified in the right kidney measuring 7.5 cm in the greatest dimension. A right radical nephrectomy with left Double J stenting was done. From histopathological and immunohistochemical staining, it was diagnosed as leiomyosarcoma.

Pulmonary artery sarcoma masquerading as a pulmonary embolism

2021 ◽  
Vol 14 (2) ◽  
pp. e232676
Author(s):  
Chevanthy Gnanalingam ◽  
Matthew Wright ◽  
Yasser Ahmed
Keyword(s):  
Pulmonary Embolism ◽  
Pulmonary Artery ◽  
Pulmonary Vascular Disease ◽  
Pulmonary Artery Sarcoma ◽  
Early Referral ◽  
Pulmonary Angiogram ◽  
Pet Ct ◽  
Ct Pulmonary Angiogram ◽  
Pet Ct Scan ◽  
Subsequent Improvement

A 52-year-old woman was referred to the respiratory team with worsening shortness of breath for the last 3 months, which had deteriorated significantly over the last 2–3 weeks. She underwent a CT pulmonary angiogram, which was reported locally as showing a large pulmonary embolism. Given the chronic history and appearance of the thrombus, the patient was referred to a specialist pulmonary vascular disease multidisciplinary team and underwent a PET-CT scan with the diagnosis being felt to be more consistent with a pulmonary artery sarcoma. Within 4 weeks, she underwent a pulmonary endarterectomy which confirmed the presence of an extensive mass. She underwent bilateral endarterectomy and pulmonary artery valve replacement, with subsequent improvement of her breathlessness back to premorbid baseline. Postoperative histology has confirmed a pulmonary artery angiosarcoma. Alternate imaging modalities and early referral to a specialist unit allowed as early a diagnosis as possible with good symptomatic benefit.

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