Presentation
Slowly progressive shortness of breath.
Patient Data
Normal chest X-ray.
The mass arising within and occluding/expanding the right pulmonary artery and its proximal branches is most suggestive of pulmonary artery sarcoma. The nodules and ground-glass opacity in the right lower lobe may represent metastases or pulmonary infarction/hemorrhage.
Increased uptake of the right pulmonary artery mass.
Case Discussion
Most pulmonary arterial filling defects are pulmonary emboli, but complete filling of the main/proximal artery with vessel expansion should suggest a diagnosis of pulmonary artery sarcoma, especially if the abnormal soft tissue density spreads beyond the vessel lumen. In this case, the FDG avidity of the mass is additional evidence that the filling defect represents a malignancy.