A rare intravascular tumour diagnosed by endobronchial ultrasound

A 24-year-old man was referred to the haematologists for investigation of unexplained anaemia on the background of a 6-month history of exertional breathlessness, mild cough and night sweats. Investigations revealed iron-deficiency anaemia (haemoglobin 94 g/L), thrombocytosis and markedly elevated inflammatory markers (C-reactive protein (CRP) 235 mg/L). A CT scan of his chest identified a large expansile filling defect within the left main pulmonary artery, almost entirely occluding the left-sided pulmonary circulation, which had high-grade 18F-fluorodeoxyglucose (FDG) uptake on a subsequent positron emission tomography (PET) CT (figure 1). The lesion was assessed via endobronchial ultrasound (EBUS), which identified a hyperechoic soft tissue mass within the left main pulmonary artery (figure 2). EBUS-guided transbronchial needle aspiration (TBNA) of the lesion was performed without complication and rapid on-site cytological evaluation confirmed a cellular aspirate. Subsequent cytological analysis revealed large sheets of fibrotic stroma intimately admixed with small delicate vessels, spindle-shaped...
Source: Thorax - Category: Respiratory Medicine Authors: Tags: Images in Thorax, Lung neoplasms, Lung cancer (oncology), Screening (oncology), Lung cancer (respiratory medicine), Cardiothoracic surgery, Radiology (diagnostics) Chest clinic Source Type: research