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Radiologic-Pathologic correlation


Primary Epithelioid Angiosarcoma of Lung: Radiologic and Clinicopathologic Correlation

Fung Him NgSan Ming YuOphelia Ka Heng WaiJames Chi Sang Chan
Department of Radiology and Organ Imaging, United Christian Hospital, Kowloon, Hong Kong
Date of Submission: 29-Jul-2016, Date of Acceptance: 28-Jun-2017, Date of Web Publication: 24-Aug-2017.
Corresponding Author:
Corresponding Author

Fung Him Ng

E-mail: ngphonehim@gmail.com

Corresponding Author:
Corresponding Author

Fung Him Ng

E-mail: ngphonehim@gmail.com

DOI: 10.4103/jcis.JCIS_71_16 Facebook Twitter Google Linkedin

ABSTRACT


Primary pulmonary angiosarcoma is extremely rare. It is often characterized by a clinically indolent course and delayed diagnosis. To date, there have been <20 cases reported. By far, little article correlates the clinical presentation, the imaging findings with the pathology. The authors present a case of middle-aged gentleman with primary pulmonary epithelioid angiosacroma which we initially thought as tuberculosis (TB) infection. A 60-year-old gentleman, with a history of 6 months on and off blood stained sputum, was admitted for an episode of massive hemoptysis. Urgent computed tomography (CT) bronchial arteriogram excluded any dilated bronchial artery. Patchy consolidation with multiple small centrilobular ground-glass nodules was noted at left upper lobe. The bronchoscopy was negative for malignancy and infection. Autoimmune workup was negative. Despite negative bronchoscopy, fungal, acid-fast bacilli culture and cytology, and anti-TB treatment were empirically given. However, his hemoptysis was unresolved. He was followed up with high-resolution CT after a month showed an enlarging left upper lobe mass surrounding by a ground glass halo. Left thoracotomy and left upper lobe lobectomy were performed. Epithelioid angiosacroma was found in histology. Radiologic and clinical-pathological findings were correlated in this paper.
Keywords: Hemoptysis, Lung Cancer, Primary Epithelioid Angiosacroma, Pulmonary Hemorrhage

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