2018 Volume 40 Issue 6 Pages 590-595
Background. Pulmonary artery intimal sarcoma is rare and is usually diagnosed based on coincidental findings on surgical specimen or at autopsy. Some reports have shown that endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is effective for the diagnosis of pulmonary artery intimal sarcoma. However, concerns remain over the risk of bleeding. Case. The patient was a 45-year-old man who had abnormal chest roentgenogram findings showing pulmonary nodules in the left lower lung field. Enhanced computed tomography (CT) of the chest revealed filling defects with heterogeneous attenuation in the left lower pulmonary artery, extending into the lower lobe pulmonary artery. PET-CT showed the uptake of FDG in the tumor. Bronchoscopy using EBUS revealed the tumor location in the vessel, pulmonary artery, and Doppler mode revealed the absence of blood flow. The patient underwent four EBUS-TBNA sessions without any complications, including bleeding. The tumor was ultimately diagnosed as pulmonary artery intimal sarcoma and treated by left pneumonectomy. Conclusion. EBUS-TBNA is considered to be a useful procedure for the diagnosis of pulmonary artery intimal sarcoma.
