Lung cancer on CTPA: extrinsic compression of pulmonary artery

Case contributed by Dr Chris O'Donnell

Presentation

Presents with right chest pain, shortness of breath and haemoptysis. CTPA to exclude pulmonary embolism. Known lung cancer.

Patient Data

Age: 80
Gender: Male

Large right lower lobe mass encircling both the lower lobe bronchus and pulmonary artery (arrow) causing marked "tapered" luminal narrowing.  Associated pleural effusion.

Case Discussion

Bronchogenic carcinoma grows around the bronchus and can encase the pulmonary vessels.  Given that they are low pressure vascular structures, extrinsic compression and occlusion can occur.  This should not be misinterpreted as vascular "cut-off" by embolism.  The key is the presence of tapered narrowing with extrinsic compression as compared with an abrupt transition due to embolism

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Case information

rID: 41930
Case created: 28th Dec 2015
Last edited: 29th Dec 2015
Systems: Vascular, Chest
Inclusion in quiz mode: Excluded

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