Primary pulmonary artery sarcoma (PAS) is an extremely rare malignant tumor with a poor prognosis. The clinical manifestations of PAS are diverse, including dyspnea, chest pain, cough, and hemoptysis. The poor prognosis is often due to delayed diagnosis caused by similarity in imaging findings with pulmonary thromboembolism (PTE). These cues of diagnosis include the “wall eclipsing sign”, lobulated bulging margins, gadolinium enhancement during MRI imaging, and FDG uptake during PET/CT imaging. However, there are still many misdiagnoses. This article reports a woman of reproductive age presenting with a pulmonary artery mass. The computed tomographic pulmonary angiography and positron emission tomography/computed tomography did not show obvious signs of pulmonary artery sarcoma, however, contrast-enhanced echocardiography showed moderate perfusion, which helped differentiate between pulmonary artery sarcoma and pulmonary artery thrombosis, leading to timely surgical treatment. PAS is a rare form of cancer that can occasionally be visually similar to PTE on radiographic images. Early diagnosis of PAS is of vital importance to the prognosis of the patients. There are several visual cues that can help differentiate between the two conditions. Additionally, contrast-enhanced echocardiography provides additional information on tumor perfusion, offering another effective approach for a prompt and accurate diagnosis.

中文翻译：

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伪装肺栓塞的原发性肺动脉肉瘤：病例报告及文献复习

原发性肺动脉肉瘤（PAS）是一种极其罕见的恶性肿瘤，预后较差。PAS的临床表现多种多样，包括呼吸困难、胸痛、咳嗽、咯血等。预后不良通常是由于影像学表现与肺血栓栓塞症（PTE）相似而导致诊断延迟。这些诊断线索包括“壁食蚀征”、分叶状膨出边缘、MRI 成像期间的钆增强以及 PET/CT 成像期间的 FDG 摄取。然而，仍然存在许多误诊。本文报道了一名育龄妇女出现肺动脉肿块。计算机断层肺血管造影和正电子发射断层扫描/计算机断层扫描未显示明显的肺动脉肉瘤征象，但超声心动图显示中等灌注，有助于区分肺动脉肉瘤和肺动脉血栓，从而及时进行手术治疗。PAS 是一种罕见的癌症，有时在放射线图像上看起来与 PTE 相似。PAS的早期诊断对于患者的预后至关重要。有几种视觉提示可以帮助区分这两种情况。此外，对比增强超声心动图提供了有关肿瘤灌注的额外信息，为及时、准确的诊断提供了另一种有效的方法。