CTICasesPulmonary Thromboembolism Mimicking Pulmonary Artery Sarcoma
Imaging findings
A chest CT demonstrates an extensive, highly unilateral filling defect in the main and lobar pulmonary arteries, exhibiting lobulated and scalloped margins that expand the vessel wall. A follow-up CT scan after anticoagulation therapy demonstrates complete resolution of the filling defect, with a companion popliteal vein thrombosis.
Key takeaways
Acute pulmonary thromboemboli can occasionally present with mass-like features, including scalloped, lobulated borders that expand the pulmonary arteries and closely mimic a primary pulmonary artery sarcoma. This is often due to in situ clot formation on top of an embolized fragment. Complete resolution of the filling defect on follow-up imaging after anticoagulation is the key to confirming a benign, thromboembolic etiology.
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