CT features analysis of primary pulmonary artery sarcoma

XU Yan; ZHENG Yaoyao; XIANG Jianyu; CHEN Jianwu; ZHOU Haisheng

doi:10.20258/j.cnki.1006-9011.2025.05.013

Abstract：Objective To explore the CT features of primary pulmonary artery sarcoma,so as to improve the understanding of the disease and reduce misdiagnosis.Method We selected 10 cases of PPAS CT examinations confirmed by pathol-ogy and mainly observed the location,range,shape,invasion and metastasis of surrounding tissues.Results 10 cases of PPAS involved the main pulmonary artery and left and right pulmonary arteries,with 9 cases involving more than 2 sites.Among the 10 cases,there were 3 cases of filling defects in the main pulmonary artery and left and right pulmonary artery trunks,2 cases of filling defects in the main pulmonary artery and left pulmonary artery trunk,1 case of filling defect in the main pulmonary artery,left and right pulmonary artery trunks,and upper and lower branches,1 case of fill-ing defect in the main pulmonary artery,left pulmonary artery trunk and upper and lower branches,and right pulmonary artery upper branch,1 case of filling defect in the main pulmonary artery and right pulmonary artery trunk,1 case of filling defect in the left and right pulmonary artery trunks,and one case of filling defect in the right pulmonary artery trunk.All 10 cases of PPAS showed complete or mostly filling defects in the main and proximal pulmonary arteries,with lesions resembling polyps,nodules,or strips,and irregular surface morphology.The density of pulmonary artery filling defects in all PPAS cases showed uneven changes,with sustained uneven mild to moderate enhancement.All 10 patients showed significant dilation of the pulmonary ar-tery in the affected segment,while the boundary of the pulmonary artery in the affected segment was blurry.Among those,3 cases invaded the arterial wall,forming masses with adjacent hilar and mediastinum,and 4 cases were shown the hilar and medi-astinal lymph node enlargement.Conclusion PPAS often invades the main pulmonary artery and left and right pulmonary artery trunks,easily involving more than two parts.The lesions are mostly in the form of polyps,nodules,or strips,with uneven den-sity and mild to moderate uneven enhancement.PPAS is characterized by strong invasiveness or metastasis.