PMC8424761_01
(a) Frontal chest radiograph demonstrates normal sized main, right and left pulmonary arteries with a small left basal pleural effusion (arrow). (b) Axial computed tomography pulmonary angiography demonstrated a filling defect extending from a dilated main pulmonary artery into the left pulmonary artery (arrows).
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The frontal radiograph revealed normal sizes of the main, right and left pulmonary arteries with a minimal left pleural effusion (Figure 1a). Computed tomography pulmonary angiography was performed because of suspected PE, which demonstrated a poorly enhancing hypodense lesion involving a dilated left main pulmonary artery and pulmonary trunk and subpleural consolidation in the left upper lobe (Figure 1b).
(a) Follow-up frontal chest radiograph revealed an enlarged main pulmonary artery and a left hilar mass (arrows). (b) Axial computed tomography pulmonary angiography demonstrated a large lobulated rim enhancing exophytic mediastinal mass extending from the dilated main pulmonary artery and the left pulmonary artery (arrows).
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The frontal chest radiograph indicated new findings of an enlarged main pulmonary artery and a left hilar mass (Figure 2a). Computed tomography PA revealed progressive enlargement of the previous poorly enhancing lesion, now involving the right and left pulmonary arteries and main pulmonary trunk with extraluminal extension into the mediastinum (Figure 2b).
Microscopic examination demonstrated high-grade malignant cells (small arrows) with massive haemorrhage (large arrows) and necrosis (asterisks).
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Histopathologic analysis of the specimen revealed high-grade malignancy with massive haemorrhage and necrosis, consistent with angiosarcoma (Figure 3).