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Brady RV, Rebhun RB, Skorupski KA, Burton JH, Al-Nadaf S, Choi E, Willcox JL. Retrospective immunohistochemical investigation of suspected non-visceral leiomyosarcoma in dogs. J Vet Diagn Invest 2022; 34:465-473. [PMID: 35291894 PMCID: PMC9254071 DOI: 10.1177/10406387221083570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Visceral leiomyosarcoma is well described in dogs, but information about non-visceral locations and prevalence is lacking. The diagnosis of leiomyosarcoma is challenging without a gold standard, and often includes the use of immunohistochemical (IHC) stains. We used defined histopathologic patterns, histochemical staining, and IHC staining for smooth muscle actin (SMA), desmin, and laminin to characterize suspected non-visceral leiomyosarcoma in dogs at a single academic institution. In a retrospective search, we identified 24 dogs with a definitive or suspected histologic diagnosis of leiomyosarcoma in a non-visceral location. Histopathology results and clinical details were obtained. Biopsy sections were reviewed by a single pathologist using standardized histologic criteria, including light microscopic appearance, immunohistochemistry (more than two-thirds of neoplastic cells labeled with SMA and desmin or laminin), and histochemical staining (minimal-to-mild matrix deposition by Masson trichrome). Of the 24 cases of possible non-visceral leiomyosarcomas, 4 were consistent with a definitive diagnosis of non-visceral leiomyosarcoma (3) or leiomyoma (1) based on the established criteria. Only the leiomyoma had more than two-thirds of neoplastic cells label with all 3 markers; all 3 leiomyosarcomas had more than two-thirds of neoplastic cells label with SMA and laminin. Our data highlight the uncommon nature of non-visceral leiomyosarcoma and the importance of IHC for their diagnosis. A definitive diagnosis could not be made based on SMA alone, and desmin was not useful in this cohort. Further studies are needed to clarify the histopathologic, IHC, and clinical features of canine non-visceral SMA-positive mesenchymal tumors.
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Affiliation(s)
- Rachel V. Brady
- Veterinary Medical Teaching Hospital
- School of Veterinary Medicine, University of
California–Davis, Davis, CA, USA. Current addresses: Department of Clinical
Sciences
| | | | | | - Jenna H. Burton
- Departments of Surgical and Radiological
Sciences
- Flint Animal Cancer Center, College of
Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort
Collins, CO, USA
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2
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Fabian NJ, Esmail MY, Richey L, Muthupalani S, Haupt JL, Joy J, Carrasco SE. Cutaneous leiomyosarcoma with visceral metastases in a White Carneau pigeon and literature review. J Vet Diagn Invest 2021; 33:1040638721992061. [PMID: 33543674 PMCID: PMC8120085 DOI: 10.1177/1040638721992061] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Cutaneous leiomyosarcomas are malignant mesenchymal tumors of smooth muscle origin and are reported occasionally in avian species. A 14-y-old male laboratory White Carneau pigeon (Columba livia) was presented for surgical excision of a cervical soft tissue mass. Ultrasonography with color flow Doppler imaging revealed multiple cavitations of mixed echogenicity within the mass and vascularization. Histologically, the dermis and subcutis were expanded by a densely cellular multinodular mass comprised of fusiform cells forming haphazardly arranged broad streams and short interwoven bundles, often surrounding blood vessels and variably sized cavitations. Neoplastic cells were strongly immunopositive for desmin and α-smooth muscle actin, and negative for pancytokeratin, S100, and von Willebrand factor. Based on histopathology and IHC findings, the cutaneous mass was diagnosed as leiomyosarcoma (LMS). The pigeon died 312 d post-operatively. Postmortem examination revealed masses infiltrating the left and right pulmonary airways and one hepatic nodule, but no regrowth at the surgical site. Histologic and IHC evaluation of the pulmonary and hepatic masses were consistent with LMS, representing metastatic foci from the primary cutaneous LMS. Our case highlights the malignant behavior and histomorphologic features of cutaneous LMS in an avian species.
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Affiliation(s)
- Niora J. Fabian
- Division of Comparative Medicine, Massachusetts Institute
of Technology, Cambridge, MA
| | | | - Lauren Richey
- Tufts Comparative Medicine Services, Tufts University,
Boston, MA
| | | | - Jennifer L. Haupt
- Division of Comparative Medicine, Massachusetts Institute
of Technology, Cambridge, MA
| | - Joanna Joy
- Division of Comparative Medicine, Massachusetts Institute
of Technology, Cambridge, MA
| | - Sebastian E. Carrasco
- Division of Comparative Medicine, Massachusetts Institute
of Technology, Cambridge, MA
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3
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Schreeg ME, Evans BJ, Allen J, Lewis MC, Luckring E, Evola M, Richard DK, Piner K, Thompson EM, Adin DB, Tokarz DA. Cardiac Leiomyosarcoma in a Cat Presenting for Bilateral Renal Neoplasia. J Comp Pathol 2019; 168:19-24. [PMID: 31103054 DOI: 10.1016/j.jcpa.2019.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Revised: 02/21/2019] [Accepted: 02/25/2019] [Indexed: 11/27/2022]
Abstract
A 10-year-old neutered female domestic longhair cat was presented to a tertiary care veterinary hospital for evaluation of a right renal mass that was identified incidentally on abdominal radiographs and classified further as a sarcoma based on fine needle aspiration cytology. Further diagnostic workup, including ultrasound and cytology, identified a sarcoma in the left kidney. After approximately 1 month of conservative medical management, the clinical condition deteriorated and the cat was humanely destroyed. Post-mortem examination confirmed bilateral renal masses with multifocal infarction and extensive necrosis, and further identified a large mass at the apex of the heart as well as multiple pulmonary nodules. Microscopical examination of the masses identified a population of poorly-differentiated neoplastic spindle cells, consistent with sarcoma. Immunohistochemically, the neoplastic cells expressed smooth muscle actin and muscle-specific actin, but were negative for myoglobin and factor VIII. Phosphotungstic acid-haematoxylin staining was unable to identify cross-striations in the neoplastic cells. Based on these results and the pattern of lesion distribution, the cat was diagnosed with cardiac leiomyosarcoma with pulmonary and bilateral renal metastasis.
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Affiliation(s)
- M E Schreeg
- North Carolina State University, College of Veterinary Medicine, 1060 William Moore Drive, Raleigh, USA
| | - B J Evans
- North Carolina State University, College of Veterinary Medicine, 1060 William Moore Drive, Raleigh, USA
| | - J Allen
- North Carolina State University, College of Veterinary Medicine, 1060 William Moore Drive, Raleigh, USA
| | - M C Lewis
- North Carolina State University, College of Veterinary Medicine, 1060 William Moore Drive, Raleigh, USA
| | - E Luckring
- North Carolina State University, College of Veterinary Medicine, 1060 William Moore Drive, Raleigh, USA
| | - M Evola
- North Carolina State University, College of Veterinary Medicine, 1060 William Moore Drive, Raleigh, USA
| | - D K Richard
- Cleveland School Animal Hospital, 79 Oxholm Circle, Garner, USA
| | - K Piner
- Veterinary Specialty Hospital of the Carolinas, 6405 Tryon Rd, Cary, North Carolina, USA
| | - E M Thompson
- North Carolina State University, College of Veterinary Medicine, 1060 William Moore Drive, Raleigh, USA
| | - D B Adin
- North Carolina State University, College of Veterinary Medicine, 1060 William Moore Drive, Raleigh, USA
| | - D A Tokarz
- North Carolina State University, College of Veterinary Medicine, 1060 William Moore Drive, Raleigh, USA.
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4
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Primary cardiac tumor presenting as left ventricular outflow tract obstruction and complex arrhythmia. J Vet Cardiol 2017; 19:441-447. [PMID: 28882531 DOI: 10.1016/j.jvc.2017.08.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2017] [Revised: 07/17/2017] [Accepted: 08/02/2017] [Indexed: 11/20/2022]
Abstract
An adult female mixed breed dog presented for recurrent collapsing episodes over several weeks. Holter evaluation revealed periods of sinus arrest and echocardiography identified a soft tissue mass with subsequent severe dynamic obstruction of the left ventricular outflow tract. The patient was euthanized five days after presentation for severe dyspnea. Necropsy revealed an irregular mass circumferentially lining the left ventricular outflow tract as well as multiple myocardial metastases. The final diagnosis was an undifferentiated pleomorphic endocardial sarcoma.
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5
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Pierini A, Cinti F, Binanti D, Pisani G. Primary leiomyosarcoma of the jugular vein in a dog. Open Vet J 2017; 7:61-64. [PMID: 28331835 PMCID: PMC5356292 DOI: 10.4314/ovj.v7i1.9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Accepted: 03/03/2017] [Indexed: 11/28/2022] Open
Abstract
A four-year-old, male, Labrador retriever was referred for removal of a spindle cell sarcoma involving the right jugular vein. A post-contrast CT scan showed a seven-centimeter subcutaneous mass originated from the right external jugular vein, which was partially obstructed and showing contrast stasis, suggested a primary intravascular tumor of the jugular vein. The mass was resected, and histological evaluation was consistent with grade II intravenous spindle cell sarcoma of the jugular vein. Immunohistochemical positivity for vimentin, desmin, and αSMA antibody and negativity for S-100 protein confirmed venous leiomyosarcoma. The dog received five doses of intravenous doxorubicin, and there was no recurrence of the tumor 30 months post treatment. In dogs, primary intravascular sarcomas are rare and primary venous leiomyosarcoma has not been described. A venous tumor may be considered as a differential diagnosis in dogs with ventral neck swelling.
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Affiliation(s)
| | - Filippo Cinti
- Centro Veterinario Luni Mare, Ortonovo (SP), 19034, Italy
| | - Diana Binanti
- AbLab, Laboratorio di Analisi Veterinarie, Sarzana (SP), 19038, Italy
| | - Guido Pisani
- Centro Veterinario Luni Mare, Ortonovo (SP), 19034, Italy
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6
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Avallone G, Helmbold P, Caniatti M, Stefanello D, Nayak RC, Roccabianca P. The Spectrum of Canine Cutaneous Perivascular Wall Tumors: Morphologic, Phenotypic and Clinical Characterization. Vet Pathol 2016; 44:607-20. [PMID: 17846233 DOI: 10.1354/vp.44-5-607] [Citation(s) in RCA: 71] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Perivascular wall tumors (PWTs) are defined as neoplasms deriving from mural cells of blood vessels, excluding the endothelial lining. The spectrum of human cutaneous PWT includes glomus tumor, hemangiopericytoma (HEP), myopericytoma, angioleiomyoma/sarcoma, angiomyofibroblastoma, and angiofibroma. The purpose of this study was to revise clinical presentation, cytology, histopathology, and immunohistology of canine cutaneous PWT with cytology typical of canine HEP. Diagnosis was established on the basis of vascular growth patterns (staghorn, placentoid, perivascular whorling, bundles from media) and immunohistology, including 7 smooth muscle markers and the cell membrane ganglioside of unknown origin recognized by the antibody 3G5 (CMG-3G5). Twenty cases were included. Ages ranged from 6 to 13 years; 12 dogs were males and 8 were females, and there was a prevalence of crossbreeds. Tumors arose from a single site with preferential acral location (10/20). Cytology revealed moderate to high cellularity in all cases, cohesive groups of cells (19/20), capillaries (18/20), and bi- to multinucleated cells (18/20). Six myopericytomas, 5 angioleiomyomas, 2 angioleiomyosarcomas, 2 HEP, 1 angiofibroma, and 1 adventitial tumor were identified. A definitive diagnosis was not possible in 3 cases. Smoothelin, heavy caldesmon, desmin, myosin, calponin, and CMG-3G5 were the most valuable markers to differentially diagnose canine PWT. Similar to reports in humans, canine HEP embodied a spectrum of neoplastic entities arising from different vascular mural cells. Before canine PWTs are assimilated into one prognostic category, a consistent classification and characterization of their biology is necessary. As proposed in humans, HEP should also be considered a diagnosis of exclusion in dogs.
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Affiliation(s)
- G Avallone
- DiPAV--Sezione Anatomia Patologica Veterinaria e Patologia Aviare, Facolta' di Medicina Veterinaria, Via Celoria 10, 20133 Milano, Italy
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7
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Stieger-Vanegas SM, Bottorff B, Sisson D, Löhr CV. IMAGING DIAGNOSIS-MULTIMODALITY FINDINGS IN AN ADULT DOG WITH PRIMARY SARCOMA OF THE PULMONARY ARTERY AND MYOCARDIAL METASTASES. Vet Radiol Ultrasound 2015; 57:E34-41. [PMID: 26596519 DOI: 10.1111/vru.12307] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Revised: 07/24/2015] [Accepted: 07/27/2015] [Indexed: 12/28/2022] Open
Abstract
Intravascular pulmonary artery sarcomas in combination with myocardial metastasis are rare in dogs. We describe the radiographic, echocardiographic, and electrocardiographic-gated (ECG-gated) computed tomographic angiography (CTA) findings in a dog with pulmonary artery sarcoma. All imaging studies demonstrated severe main pulmonary artery enlargement. Echocardiography and ECG-gated CTA revealed a mass occluding the lumen of the right pulmonary artery. In addition, CTA revealed focal left ventricular myocardial contrast enhancement and parenchymal lung changes. Postmortem examination confirmed the presence of a large thrombus associated with arteriosclerosis and an intravascular sarcoma in the right pulmonary artery with metastases to the myocardium, lungs and brain.
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Affiliation(s)
- Susanne M Stieger-Vanegas
- Department of Clinical Sciences, College of Veterinary Medicine, Oregon State University, Corvallis, OR, 97331
| | | | - David Sisson
- Department of Clinical Sciences, College of Veterinary Medicine, Oregon State University, Corvallis, OR, 97331
| | - Christiane V Löhr
- Department of Biomedical Sciences, College of Veterinary Medicine, Oregon State University, Corvallis, OR, 97331
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8
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Kohnken R, Durham JA, Premanandan C, Scansen BA. Aortic chondroid neoplasia in two Labrador Retriever dogs. J Vet Cardiol 2015; 17:314-20. [PMID: 26521222 DOI: 10.1016/j.jvc.2015.08.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Revised: 08/06/2015] [Accepted: 08/11/2015] [Indexed: 12/27/2022]
Abstract
In the same week, two Labrador Retriever dogs presented to The Ohio State University Veterinary Medical Center for cardiac evaluation. The presenting signs in both dogs included: weight loss, weakness, lethargy, and decreased femoral pulses. The first dog presented in cardiogenic shock and biventricular congestive heart failure, which initially responded to treatment; however, the dog was euthanized due to deteriorating clinical condition. In contrast, the second dog had a milder clinical course without signs of congestive heart failure, and remained stable over the 2-month period of clinical evaluation prior to euthanasia. Echocardiographic evaluation revealed a dilated cardiomyopathy phenotype in the first dog, while a space-occupying intraluminal mass originating at the aortic valve with preserved left ventricular systolic function was observed in the second dog. At autopsy, each dog had a large obstructive luminal mass affecting the ascending aorta and arch. Histopathology revealed that the mass in the first dog was consistent with a benign chondroma, while in the second dog the morphologic characteristics, mitotic activity, and infiltrative growth justified a diagnosis of chondrosarcoma. This report presents the contrasting clinical disease progression and findings in two dogs with aortic neoplasia, with a proposed pathogenesis of cardiac failure secondary to aortic neoplasia.
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Affiliation(s)
- R Kohnken
- Department of Veterinary Biosciences, College of Veterinary Medicine, The Ohio State University, 601 Vernon L Tharp St, Columbus, OH 43210, USA.
| | - J A Durham
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, 601 Vernon L Tharp St, Columbus, OH 43210, USA
| | - C Premanandan
- Department of Veterinary Biosciences, College of Veterinary Medicine, The Ohio State University, 601 Vernon L Tharp St, Columbus, OH 43210, USA
| | - B A Scansen
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, 601 Vernon L Tharp St, Columbus, OH 43210, USA
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9
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Bryan J, De Swarte M, Tamborini A, Jahns H. Primary pulmonary artery osteosarcoma in a dog. VETERINARY RECORD CASE REPORTS 2014. [DOI: 10.1136/vetreccr-2014-000088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Jill Bryan
- Department of Veterinary PathobiologySchool of Veterinary MedicineDublinIreland
| | - Marie De Swarte
- Department of Diagnostic ImagingUniversity College Dublin Veterinary HospitalDublinIreland
| | - Alice Tamborini
- Department of Small Animal Internal MedicineUniversity College Dublin Veterinary HospitalDublinIreland
| | - Hanne Jahns
- Department of Veterinary PathobiologySchool of Veterinary MedicineDublinIreland
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10
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Vogler BR, Vetsch E, Wernick MB, Sydler T, Wiederkehr DD. Primary leiomyosarcoma in the heart of a guinea pig. J Comp Pathol 2012; 147:452-4. [PMID: 22770427 DOI: 10.1016/j.jcpa.2012.04.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2011] [Revised: 03/16/2012] [Accepted: 04/26/2012] [Indexed: 11/16/2022]
Abstract
Leiomyosarcoma was diagnosed in the heart of a 3-year-old female guinea pig. Neoplastic tissue was located in the ventricular septum extending into the right ventricular lumen, but was not obvious grossly. Microscopically, the mass was nodular and infiltrative and was composed of streams and bundles of spindle cells. Immunohistochemically, the neoplastic cells expressed vimentin and α-smooth muscle actin. There was no cross striation of the muscle cells. This is the first report of cardiac leiomyosarcoma in a guinea pig.
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Affiliation(s)
- B R Vogler
- Clinic for Zoo Animals, Exotic Pets and Wildlife
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11
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Chanoit G, Mathews KG, Keene BW, Small MT, Linder K. Surgical treatment of a pulmonary artery vascular hamartoma in a dog. J Am Vet Med Assoc 2012; 240:858-62. [DOI: 10.2460/javma.240.7.858] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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12
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Gallay J, Bélanger MC, Hélie P, Côté E, Johnson TO, Peters ME. Cardiac leiomyoma associated with advanced atrioventricular block in a young dog. J Vet Cardiol 2011; 13:71-7. [DOI: 10.1016/j.jvc.2010.11.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2010] [Revised: 10/14/2010] [Accepted: 11/10/2010] [Indexed: 11/15/2022]
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13
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14
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Rossdale PD, Greet TRC, McGladdery AJ, Ricketts SW, Aqel N. Pulmonary leiomyosarcoma in a 13-year-old Thoroughbred stallion presenting as a differential diagnosis to recurrent airway obstruction. EQUINE VET EDUC 2010. [DOI: 10.1111/j.2042-3292.2004.tb00263.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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15
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Ranck RS, Linder KE, Haber MD, Meuten DJ. Primary Intimal Aortic Angiosarcoma in a Dog. Vet Pathol 2008; 45:361-4. [DOI: 10.1354/vp.45-3-361] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
A primary intimal aortic angiosarcoma was diagnosed in a 4-year-old, spayed female German Shepherd that presented for complications of thromboembolic disease because of infarcts in multiple organs. On gross examination, aneurysmal dilatation of the aorta was associated with a friable, necrotic mass attached to the endothelial surface, which partially occluded the aortic lumen. On histologic examination, plump neoplastic spindle cells formed a plaque-like mass arising from the intima that merged with a large accumulation of fibrin and necrotic debris, and projected into the lumen. Neoplastic cells invaded periaortic vessels and were seen in some infarct-associated thromboemboli. Tumor cells expressed vimentin and CD31, with infrequent, patchy staining with factor VIII-related antigen; tumor cells were negative for cytokeratin and smooth-muscle actin. Aortic angiosarcoma is a rare malignancy in humans. This is the first description of a primary intimal aortic angiosarcoma in a dog, with immunohistochemical evidence of endothelial origin.
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Affiliation(s)
- R. S. Ranck
- Department of Population Health and Pathobiology, North Carolina State University College of Veterinary Medicine, Raleigh, NC
| | - K. E. Linder
- Department of Population Health and Pathobiology, North Carolina State University College of Veterinary Medicine, Raleigh, NC
| | - M. D. Haber
- Department and Clinical Sciences, North Carolina State University College of Veterinary Medicine, Raleigh, NC
| | - D. J. Meuten
- Department of Population Health and Pathobiology, North Carolina State University College of Veterinary Medicine, Raleigh, NC
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Abstract
We report the case of a 4-year-old female woodchuck (Marmota monax) which presented with a white, firm and discrete mass in the hard palate. The mass extended into the oral cavity but it was well separated from the surrounding tissues. Histology of the tumor showed a malignant mesenchymal tumor with pleomorphic spindle cells varying in degrees of differentiation and density. The neoplastic cells had moderate amounts of granular or fibrillar eosinophilic cytoplasm with indistinct cell margins. Nuclei were oval to elongated and frequently blunt-ended with vesicular chromatin. Immunohistochemical study showed that the neoplastic cells expressed vimentin and alpha-smooth muscle actin but did not express desmin, pan-cytokeratin, and S-100. Therefore, histology and immunohistochemistry revealed that the tumor was oral leiomyosarcoma. Oral cavity is an extremely rare site for leiomyosarcoma and the present case is the first report of spontaneous oral leiomyosarcoma in animals.
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Affiliation(s)
- Byeong-Cheol Kang
- Xenotransplantation Research Center, Seoul National University Hospital, Seoul 110-744, Korea
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17
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Kim JH, Gutierrez FR, Lee EY, Semenkovich J, Bae KT, Ylagan LR. Primary leiomyosarcoma of the pulmonary artery: a diagnostic dilemma. Clin Imaging 2003; 27:206-11. [PMID: 12727062 DOI: 10.1016/s0899-7071(02)00568-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Primary leiomyosarcoma of the pulmonary artery is a rare malignancy arising from the multipotential mesenchymal cell of the intima of the pulmonary artery. Due to its rarity and nonspecific clinical symptoms, the correct diagnosis and proper management are often delayed. Furthermore, it is frequently misdiagnosed as pulmonary embolism, mediastinal mass, pulmonary stenosis and lung cancer. Therefore, it is important to consider primary leiomyosarcoma of the pulmonary artery a possibility when a persistent filling defect is present in the pulmonary artery and there is no response to optimal anticoagulation treatment. Radiologic findings such as a unilateral mass continuously filling the pulmonary artery, inhomogenous enhancement, vascular distension, extravascular invasion into adjacent structure or uptake in the area of tumor on the FDG-PET can be helpful when differentiating pulmonary artery sarcoma (PAS) from chronic thromboembolism.
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Affiliation(s)
- Jin-Hwan Kim
- Department of Radiology, Mallinckrodt Institute of Radiology, Washington University Medical Center, 510 South Kingshighway Boulevard, St. Louis, MO 63110, USA
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