PMC4756197_01
(A) Transverse section of chest computed tomography in lung window showing a large left lower lobe mass. (B) Transverse section of chest computed tomography in a mediastinal window demonstrating the close involvement of the mass with the inferior pulmonary veins.
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Initial imaging, including a chest CT and PET, revealed an isolated left hilar mass measuring 5.5 x 3.9 x 6.1 cm (Fig. 1A & B) which was intensely hypermetabolic without uptake elsewhere (Fig. 2).
Spindle shaped tumor cells arranged in ill-defined fascicles and nodules. A central focus of necrosis is present (arrow).
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Final pathology demonstrated a high-grade leiomyosarcoma measuring 7.0 x 6.5 x 5.2 cm (Fig. 3).
Tumor infiltrating pulmonary vein.
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Bronchial and pulmonary artery margins were negative for malignancy, however, tumor was found to microscopically invade the pulmonary venous wall, extending into atrial endomyocardium (Fig. 4).