PMC4677584_01
Extensive intravascular filling defects of bilateral pulmonary arteries (red arrows).
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F0001
Her dyspnea had been progressively worsening during this time, and serial CT scans showed cardiomegaly with pulmonary emboli involving the right and left main pulmonary arteries with extension into the right and left upper and lower lobe branches (Fig. 1).
The right ventricular (RV) cavity dilation with a thickened wall. The distorted interventricular septum (IVS) is pushed toward the left ventricular (LV) cavity.
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F0002
The interventricular septum was distorted and pushed toward the left ventricular cavity (Fig. 2).
The markedly congested lungs. A lobulated, pale, yellow mass is occupying the entire volume of the right and left main pulmonary arteries, loosely adherent to the pulmonary artery at multiple locations and measuring 13 cm in greatest dimension. The pulmonary artery mass extended into the parenchyma of the right upper lobe, 6 cm in greatest dimension.
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F0003
The pulmonary artery mass extended into the parenchyma of the right upper lobe, 6 cm in greatest dimension (Fig. 3).
The cells are positive for desmin and vimentin and showed focal reactivity for actin. This is consistent with a high-grade primary pulmonary artery leiomyosarcoma.
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F0004
Overall, this was consistent with high-grade primary pulmonary artery leiomyosarcoma (Fig. 4).