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Abstract

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Article in Japanese

Case Report

An autopsy case of pulmonary artery sarcoma with pulmonary aspergillosis and aortic dissection

Haruka Machiia  Toshihiko Yokoyamab  Mitsuki Tanimotoc  Yuiko Yokoyamad  Masayasu Inagakib  Yusuke Tsushimab 

aDepartment of Respiratory Medicine, Nagoya Ekisaikai Hospital
bDepartment of Respiratory Medicine, Japanese Red Cross Aichi Medical Center Nagoya Daiichi Hospital
cDepartment of Respiratory Medicine, Tsushima City Hospital
dDepartment of Respiratory Medicine, Meijo Hospital

ABSTRACT

A 69-year-old woman with a history of aortic dissection was referred to our department due to an abnormal chest X-ray. Contrast-enhanced computed tomography (CT) revealed a 60-mm heterogeneously enhanced mass in the left hilum and lesions seen as filling defects in the lumen of the main trunk and left lower branch of the pulmonary artery. Bronchoscopy revealed thrombus occlusion in the left upper lobe bronchus, and a large amount of Aspergillus sp. hyphae were detected in the lavage fluid, so we administered antifungal agents in combination with antibacterial agents. Intrapulmonary artery aspiration cytology of the lesion in the pulmonary artery and a thoracoscopic needle biopsy of the hilar lesion were performed, with a suspicion of pulmonary artery sarcoma. However, a definitive diagnosis could not be obtained in life. After treatment, the left hilar lesion reduced in size, whereas the intravascular lesions increased. The patient died of hemoptysis 6 months after her first visit. Pathological findings on autopsy revealed a pulmonary artery sarcoma localized in the pulmonary artery and granulomatous tissue in the left hilar lesion. Her clinical course and pathological findings strongly suggested a complication of pulmonary aspergillosis.

KEYWORDS

Pulmonary artery sarcoma  Pulmonary aspergillosis  Autopsy  Aortic dissection 

Received 26 Aug 2021 / Accepted 8 Dec 2021

AJRS, 11(2): 87-91, 2022

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