CTICasesPulmonary Artery Sarcoma
Imaging findings
Contrast-enhanced chest CT demonstrates a large, expanding filling defect in the main pulmonary artery extending into the main branches, showing irregular enhancement and scalloping of the vessel wall. On follow-up, the mass shows progression and failure to resolve despite anticoagulation therapy, accompanied by downstream nodular infarcts in the lungs.
Key takeaways
Pulmonary artery sarcoma is an extremely rare, highly aggressive malignant neoplasm that is frequently misdiagnosed as acute or chronic pulmonary embolism. Distinguishing features on CT include a filling defect occupying the entire lumen of the main pulmonary artery, direct vessel expansion, scalloped margins, and heterogeneous contrast enhancement of the mass reflecting tumor vascularity rather than avascular thrombus.
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