CTICasesPulmonary Artery Thrombus with Shaggy Margin Mimicking Sarcoma
Imaging findings
A pulmonary artery filling defect with a shaggy margin, previously larger and called a sarcoma at an outside institution, was treated with anticoagulation. MRI, including a 600 ms delayed inversion-time sequence, shows the material to be dark relative to normal soft tissue with nothing outside the vessel, confirming clot.
Key takeaways
A shaggy-margined pulmonary artery filling defect can raise concern for sarcoma, but anticoagulation itself can produce the shaggy appearance as clot retracts. A delayed inversion-time MRI sequence in which the material nulls dark (unlike enhancing tumor) confirms bland thrombus and excludes an extravascular tumor component.
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