Presentation
History withheld.
Patient Data
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Left hilar mass. Associated small pleural fluid collection on the left.
Remainder of the lung and cardiomediastinal contour is within normal limits.
No destructive bony lesions.
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A large lobulated partially calcified mass arises in and concludes the main left pulmonary artery. It measures 5.5 x 5.4 x7 cm and extends into segmental branches for the upper and lower lobes.
Stranded soft tissue pleural density is noted posterolaterally in the left lower lobes and also in the upper lobe. This is associated with a small amount of fluid tracking into the superior portion of the oblique fissure. In addition there are several areas of wedge shaped ground glass opacities peripherally in the left upper lobe.
There is no mediastinal lymph node enlargement and no pulmonary nodules are seen. No destructive bone lesions are seen.
Case Discussion
The patient proceeded to an open biopsy and pulmonary artery leiomyosarcoma was identified on histology.