Primary pulmonary artery sarcoma complicated with pulmonary embolism and pulmonary tuberculosis: A case report and literature review.

Abstract

A case of primary pulmonary artery sarcoma (PPAS) complicated with pulmonary embolism and pulmonary tuberculosis is reported. This patient, a 48-year old woman, was diagnosed as pulmonary tuberculosis at the initial stage of the disease, whose condition was improved after anti-tuberculosis treatment, and was finally diagnosed as PPAS combined with pulmonary embolism due to recurrence of the symptoms. PPAS is a very rare malignant tumor originating from the inner or subintima of the pulmonary artery. The clinical manifestations of PPAS have no obvious specificity which can be dyspnea, chest pain, cough, hemoptysis, and so on. Enhanced CT, enhanced MRI, and positron emission computed tomography (PET/CT) is beneficial to the differential diagnosis of PPAS, but definitive diagnosis needs intravascular biopsy or surgical biopsy. Because PPAS often presents as pulmonary embolism, patients with PPAS were often misdiagnosed as pulmonary embolism, resulting in delayed diagnosis and treatment. There are few reports of PPAS presenting as pulmonary embolism complicated with pulmonary tuberculosis at home and abroad, which is also easy to be misdiagnosed. The disease has a high degree of malignancy, which is short of effective treatment at the late stage, with short survival time and poor prognosis. Therefore, attention to the various clinical manifestations of PPAS and early diagnosis and treatment are crucial to the prognosis of PPAS patients.