scholarly journals A Case of Pulmonary Sarcoma with Significant Extension into the Right Lung

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Yoshiaki Inoue ◽  
Yotaro Izumi ◽  
Kenjiro Sakaki ◽  
Keiko Abe ◽  
Teruaki Oka ◽  
...  

A female patient in her 30s was referred to us with a mass approximately 8 centimeters in diameter in right lung segment 6. Bronchoscopy was done, and a tumorous lesion obstructing right B6 was found. Biopsy of this lesion supported suspicions of sarcoma or spindle cell carcinoma. Contrast-enhanced CT showed that the mass extended to and obstructed the right main pulmonary artery. A skip lesion was also suspected in the periphery of pulmonary artery trunk. The tumor was removed by right pneumonectomy accompanied by resection of the main and left pulmonary arteries under cardiopulmonary bypass. The pulmonary artery trunk and the left pulmonary artery were reconstructed with a vascular graft. Collectively, intimal sarcoma originating from the right main pulmonary artery with extension into the right lung was diagnosed. Significant extension of pulmonary artery sarcoma into the lung, as was observed in the present case, is considered to be rare, and to our knowledge this is the first report in which the primary lesion was biopsied by bronchoscopy.

1985 ◽  
Vol 107 (4) ◽  
pp. 368-375 ◽  
Author(s):  
E. Philpot ◽  
A. P. Yoganathan ◽  
H.-W. Sung ◽  
Y.-R. Woo ◽  
R. H. Franch ◽  
...  

In-vitro pulsatile flow visualization studies were conducted in an adult-sized pulmonary artery model to observe the effects of valvular pulmonic stenosis on the flow fields of the main, left and right pulmonary arteries. The flow patterns revealed that as the degree of stenosis increased, the jet-type flow created by the valve became narrower, and it impinged on the far (distal) wall of the left pulmonary artery further downstream from the junction of the bifurcation. This in turn led to larger regions of disturbed turbulent flow, as well as helical-type secondary flow motions in the left pulmonary artery, compared to the right pulmonary artery. The flow field in the main pulmonary artery also became more disturbed and turbulent, especially during peak systole and the deceleration phase. The flow visualization observations have been valuable in helping to conduct further quantitative studies such as pressure and velocity field mapping. Such studies are important to understanding the fluid mechanics characteristics of the main pulmonary artery and its two major branches.


2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Hyun-Hwa Cha ◽  
Hae Min Kim ◽  
Won Joon Seong

Abstract Background Unilateral pulmonary artery discontinuity is a rare malformation that is associated with other intracardiac abnormalities. Cases accompanied by other cardiac abnormalities are often missed on prenatal echocardiography. The prenatal diagnosis of isolated unilateral pulmonary artery discontinuity can also be delayed. However, undiagnosed this malformation would have an effect on further prognosis. We report our case of a prenatal diagnosis of pulmonary atresia with ventricular septal defect and left pulmonary artery discontinuity. Case presentation A 33-year-old Asian woman visited our institution at 24 weeks of gestation because of suspected fetal congenital heart disease. Fetal echocardiography revealed a small atretic main pulmonary artery giving rise to the right pulmonary artery without bifurcation and the left pulmonary artery arising from the ductus arteriosus originating from the left subclavian artery. The neonate was delivered by cesarean section at 376/7 weeks of gestation. Postnatal echocardiography and multidetector computed tomography showed a right aortic arch, with the small right pulmonary artery originating from the atretic main pulmonary artery and the left pulmonary artery originating from the left subclavian artery. Patency of the ductus arteriosus from the left subclavian artery was maintained with prostaglandin E1. Right ventricular outflow tract reconstruction and pulmonary angioplasty with Gore-Tex graft patch was performed 25th day after birth. Unfortunately, the neonate died because of right heart failure 8 days postoperation. Conclusion There is a possibility that both pulmonary arteries do not arise from the same great artery (main pulmonary artery or common arterial trunk). Therefore, clinicians should check the origin of both pulmonary arteries.


1995 ◽  
Vol 117 (2) ◽  
pp. 237-241
Author(s):  
H. Katayama ◽  
G. W. Henry ◽  
C. L. Lucas ◽  
B. Ha ◽  
J. I. Ferreiro ◽  
...  

We studied the detailed profiles of blood flow in the right and left pulmonary arteries using 20 MHz pulsed Doppler ultrasound equipment in a lamb model. Fourteen lambs aged four to six weeks were selected. In six lambs, monocrotaline pyrrole was injected parenterally to create pulmonary hypertension (PH group). Eight other lambs served as unaltered controls (control group). The blood flow velocities were sampled in 1mm increments along the anterior—posterior axis of the branch arteries. The maximum velocity of the forward flow in the left pulmonary artery was higher than that in the right pulmonary artery in the control group (71.7 ± 15.9cm/s vs 60.2 ± 13.5; p < 0.05). The fastest backward flow was located at the posterior position of the vessel in the right pulmonary artery in the control group. No significant bias in location was shown in the left pulmonary artery. Using indices of P90, acceleration time, P90*AcT, the velocity waveforms in the PH group were compared with those in the control group. In the left pulmonary artery, every index in the control group showed a significantly greater value that in the PH group. On the other hand, no significant differences were found between either group in the right pulmonary artery.


1960 ◽  
Vol 15 (1) ◽  
pp. 92-96 ◽  
Author(s):  
Dali J. Patel ◽  
Donald P. Schilder ◽  
Alexander J. Mallos

The relationship between instantaneous distending pressure and diameter of the pulmonary artery was studied in 18 living thoracotomized dogs. An electrical caliper with adequate recording characteristics was developed for instantaneous diameter measurement. Control observations were made over a range of pressures induced by rapid, right heart dextran-infusion and were compared with those obtained during norepinephrine administration. Results indicate: a) the pulse contours of the pulmonary artery pressure and diameter are essentially identical, indicating negligible inertance and viscous resistance of the vessel wall, b) the mean change in average radius during a cardiac cycle was ±7.8% ± 2.86 S.D. ± .32 S.E.M. (0.48%/cm H2O pulse pressure) under control conditions, c) the ratio of change in radius to pulse pressure, R/P, showed a significant decrease during norepinephrine administration when compared to control values within the same pressure range (P < .01) and d) the cross-sectional area of the main pulmonary artery exceeded that of the right and left combined. Note: (With the Technical Assistance of Alfred G. T. Casper) Submitted on August 25, 1959


1992 ◽  
Vol 2 (2) ◽  
pp. 179-183
Author(s):  
Deborah M. Friedman ◽  
John Fernandes ◽  
Monika Rutkowski ◽  
Delores Danilowicz

AbstractA common systolic ejection murmur of the neonate has been attributed to physiologic peripheral pulmonic stenosis. We investigated this auscultatory finding using duplex pulsed Doppler. Three groups of normal fuliterm neonates less than one week old were studied—10 without murmurs, 10 with grade 1/6 murmurs and nine with at least grade 2/6 murmurs. We measured the anatomical size and peak flow velocities in the main pulmonary artery and left and right branches, the peak velocity in the right ventricular outflow tract, and the bifurcation angle. Flow gradients were calculated as 4 (Vmax)2 Groups were compared by t-tests. A loud peripheral pulmonic stenosis murmur was associated with increased pulmonary artery velocities, with left pulmonary artery velocity the most discriminating variable (1.3 ± 0.29 vs 0.94 ± 0.19 m/s; p ≤ 0.05). Although the peak gradient never exceeded 12 mmHg, there was an increased gradient in the loud murmur group (8.7 ± 2.6 vs 5.7 ± 2.2 mmHg; p ≤ 0.05) which may even be underestimated by the lack of angle correction. The left pulmonary artery diameter was also larger in the loud murmur group, but there were no other anatomic or volumetric flow differences between groups. The soft murmur group could not be separated from normals. We conclude that Doppler techniques can confirm the physiologic basis of peripheral pulmonic stenosis murmurs.


2000 ◽  
Vol 10 (4) ◽  
pp. 419-422 ◽  
Author(s):  
Astolfo Serra ◽  
Francisco Chamie ◽  
R.M. Freedom

AbstractMajor abnormalities of pulmonary circulation are uncommon in the patient with pulmonary atresia and intact ventricular septum. Non-confluent pulmonary arteries have only rarely been described in this setting. In this case report, we describe a patient in whom the pulmonary arteries are non-confluent, with the right pulmonary artery supplied through a right-sided arterial duct, and the left pulmonary artery most likely through a fifth aortic arch, thus providing a systemic-to-pulmonary arterial connection. We discuss the various forms of non-confluent pulmonary arteries in the setting of pulmonary atresia and intact ventricular septum.


2021 ◽  
Vol 13 (3) ◽  
pp. 254-257
Author(s):  
İlker Mercan ◽  
Muhammet Akyuz ◽  
Onur Işık

Pulmonary arterial sling (PAS) is a relatively rare congenital anomaly in which left pulmonary artery branch originates abnormally from the right pulmonary artery, eventually resulting with respiratory symptoms, due to airway obstruction. In this report, we present a PAS in a neonate who showed progressive respiratory distress in the second week following delivery. At 25 days of age, the patient underwent total surgical correction of the anomaly, during which left pulmonary artery reimplantation to main pulmonary artery without the use of cardiopulmonary bypass was employed. Following an uneventful recovery, the patient was discharged eighteen days after surgery.


2020 ◽  
Vol 10 ◽  
pp. 5
Author(s):  
Pierre D. Maldjian ◽  
Kevin R. Adams

We report a case of a partial anomalous left pulmonary artery sling in an adult patient as an incidental finding on computed tomography. There is a normal bifurcation of the pulmonary trunk into right and left pulmonary arteries with anomalous origin of the left upper lobe pulmonary artery from the right pulmonary artery. The anomalous vessel passes between the trachea and esophagus forming a partial left pulmonary artery sling without airway compression.


2021 ◽  
Author(s):  
Yusen Feng ◽  
Pengcheng Ma ◽  
Lijuan Wang ◽  
Guifang Sun ◽  
Bin Liu ◽  
...  

Abstract Objective: This study is designed to explore the dual-source computed tomography (DSCT) imaging manifestations of the origin of three rare pulmonary artery abnormalities, and to improve the understanding and diagnosis of the disease.Methods: Collected 30 cases of patients diagnosed by DSCT with pulmonary artery abnormal origins, and retrospectively analyzed their imaging data and postoperative pathological data.Results: Among the 30 patients with abnormal pulmonary artery origin, 16 patients were with unilateral pulmonary artery absence (UAPA), 8 patients were with anomalous origin of unilateral pulmonary artery (AOPA), and 6 patients were left pulmonary artery suspension (LPAS). The diagnosis rate of DSCT is significantly higher than that of echocardiography. The results of DSCT imaging showed that the inner diameter of the ascending aorta, the aortic arch and the descending aorta of UAPA patients were significantly larger than those of LPAS patients (P<0.05). Compared with AOPA patients, the left pulmonary artery diameter, the ratio of the left main pulmonary artery diameter to the main pulmonary artery diameter, and ratio of the left main pulmonary artery diameter to the right main pulmonary artery diameter were significantly increased in UAPA patients (P<0.05). There was no significant difference in the ratio of the inner diameter of the ascending aorta to the descending aorta in patients with UAPA, AOPA and LPAS. Compared with UAPA patients, AOPA patients had no significant changes in the inner diameter of the main pulmonary artery, the inner diameter of the right main pulmonary artery, and the ratio of the inner diameter of the right main pulmonary artery to the main pulmonary artery.Conclusion: DSCT can be used to diagnose the origin of pulmonary artery abnormalities and distinguish its types.


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