Type:
Educational Exhibit
Keywords:
Thorax, Pulmonary vessels, Oncology, CT-Angiography, PET-CT, MR, Contrast agent-intravenous, Diagnostic procedure, Education, Cancer, Embolism / Thrombosis
Authors:
D. Attinà, F. Niro, P. Tchouante, M. Zompatori; Bologna/IT
DOI:
10.1594/ecr2013/C-0036
Conclusion
PAS is a highly aggressive and rapidly evolving disease,
underdiagnosed and misunderstood.
Early diagnosis with the help of integrated imaging remains today the main road to pursue in order to obtain improvements in prognosis.
Angio-CT images in the presence of a filling defect with contrast enhancement in the pulmonary artery should put the suspicion of malignancy and the hypothesis should be confirmed by a high uptake on CT-PET with FDG or contrast MRI hyperintensity.
The presence of tumor extraluminal extension as well as distant metastases are reliable signs of differential diagnosis between PAS and pulmonary embolism,
but these are manifestations of advanced cancer.
For these reasons,
the radiologist must be aware of the imaging characteristics of this rare disease to be able to put the suspicion of PAS in patients with severe dyspnea and filling defect in the pulmonary artery unresponsive to anticoagulation therapy.