PMC6116662_01
Contrast-enhanced computed tomography findings: (a) axial computed tomography scan shows a large filling defect in the left pulmonary artery consistent with obliterative thrombosis (arrow) with extraluminal tumor extension. (b) Coronal and (c) apical axial computed tomography scan in the same patient revealed a soft-tissue mass with the cavity in the left upper lobe (arrows)
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F1
There was another 37x15mm large soft tissue-like lesion in posterobasal area of the left hemithorax [Figure 1a]. In the anterior segment of the left upper lobe there was a 47x31 mm (AP/LL) cavitation found with a mass in the posterior wall [Figure 1b and c].
Various types of cellularity of pulmonary artery intimal sarcoma: (a) small, round tumor cells in cellular area of pulmonary artery intimal sarcoma (H and E, x20); (b) the same cells in myxoid background of tumor with (H and E, x20); (c) zone of pulmonary artery intimal sarcoma with mixed, hypo- and hypercellularity (H and E, x20)
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F2
Zones of hyper- and hypocellularity zones were observed in the tumor [Figure 2a-c].
Immunohistochemistry confirmed diagnosis of pulmonary artery intimal sarcoma: (a) tumor cells expressed vimentin improving their mesenchymal origin, x20; (b) alpha-smooth muscle actin was expressed in small, round tumor cells; (c) CD31 was expressed in tumor cells, x20; (d) the high proliferative activity was detected by Ki-67, x20
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F3
All tumor cells expressed vimentin [Figure 3a], and most of them expressed alpha-SMA [Figure 3b] and CD31 [Figure 3c]. Both hypo- and hypercellular zones were with high mitotic activity, of about 80% [Figure 3d].