PMC8257387_01
A contrast-enhanced computed tomography scan showing a tumor (arrow) in the right main pulmonary artery.
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A computed tomography (CT) scan showed a low-attenuation defect in the lumen of the right main pulmonary artery (Figure 1).
A pulmonary angiogram revealing tumor of the right main pulmonary artery. The catheter is attached to the filling defect, and vacuum suction is performed.
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Vacuum suction of the mass was performed several times by careful manipulation (Figure 2).
An occlusive tumor in the main pulmonary artery (arrow) of resected specimen.
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The gross specimen showed that yellowish solid mass, 9 x 5 x 3 cm in size, was occluding the right main pulmonary artery (Figure 3).
Histopathology of intimal sarcoma (x200). (a) Hematoxylin and eosin stain showing atypical spindle-shaped tumor cells. (b) Immunohistochemical staining showing positive staining for murine double minute type 2 homologue. (c) Immunohistochemical staining showing positive staining for vimentin. (d) Immunohistochemical staining showing positive staining for alpha smooth muscle actin. (e) Immunohistochemical staining showing negative staining for desmin. (f) Elastica-van-Gieson staining showed tumor cells invading outside pulmonary artery. Arrows indicate that the wall of pulmonary artery was destroyed by tumor invasion.
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Immunohistochemical staining was positive for vimentin, murine double minute type 2 homologue, and alpha smooth muscle actin (Figure 4), negative for desmin, factor VIII, CD34, and CD31.