scholarly journals Primary Intimal Sarcoma of the Pulmonary Artery in a 25-Year-Old Woman with Dyspnea and Palpitation: A Case Report

2021 ◽  
pp. 318-324
Author(s):  
Hiroko Onagi ◽  
Yoshiya Horimoto ◽  
Takashi Arai ◽  
Hiroyuki Terukina ◽  
Tohru Asai ◽  
...  
Keyword(s):  
Pulmonary Artery ◽  
Correct Diagnosis ◽  
Intimal Sarcoma ◽  
Vessel Lumen ◽  
Contrast Enhanced ◽  
Japanese Female ◽  
Old Japanese ◽  
Chief Complaints ◽  
The Right ◽  
Tunica Intima

Intimal sarcoma arising from the tunica intima of both systemic and pulmonary circulations is a rare disorder, whereas intimal sarcoma with chondroblastic osteosarcomatous differentiation (ISCOS) is even rarer. We present the case of a 25-year-old woman with ISCOS of the pulmonary artery (PA) where the patient went through surgical treatment after careful imaging assessment under a rather emergent situation. A 25-year-old Japanese female presented to our hospital with the chief complaints of dyspnea and palpitations on exertion. Upon arrival, she had systolic murmur, moderate tricuspid regurgitation, and possible pulmonary hypertension. A contrast-enhanced chest computed tomography (CT) showed dilatation of the main PA, filled with a hypodense area with calcification adjacent to the right and left PA. The calcified lesions within the tumor were the key findings suggesting osteoid-forming sarcoma, differentiating it from pulmonary embolism. Due to presence of critical symptomatic obliteration of the pulmonary circulation, an emergency surgery was performed. A whitish shiny mass filled the lumens from the main PA to the bilateral main PAs. The tumor was not attached to the surrounding intima, except for a slight attachment to the left interlobar PA, and could be completely removed from the vessel lumen. Based on the pathological findings, it was diagnosed as a primary ISCOS of the PA, which correlated with the findings of the CT, namely intratumoral calcification. Although the diagnosis-making is quite challenging, multidisciplinary collaboration between clinicians, radiologists, and pathologists is crucial for reaching the correct diagnosis.

scholarly journals A Case of Fascioliasis Treated Successfully without Sequelae in a Japanese Expatriate Living in Jakarta

2015 ◽  
Vol 8 ◽  
pp. CCRep.S26578 ◽  
Author(s):  
Masataro Norizuki ◽  
Teppei Sasahara ◽  
Harumi Gomi ◽  
Yuji Morisawa ◽  
Noriko Takamura ◽  
...  
Keyword(s):  
Upper Class ◽  
Intermittent Fever ◽  
Contrast Enhanced ◽  
Japanese Female ◽  
Old Japanese ◽  
History Of ◽  
Fasciola Spp ◽  
Enhanced Computed Tomography ◽  
The City ◽  
Contrast Enhanced Computed Tomography

A 46-year-old Japanese female expatriate living in Jakarta presented with intermittent fever lasting for a month. Although she was considered at low risk of Fasciola spp. infection because she lived in an upper-class residential area of the city, the patient presented with eosinophilia after consuming organic raw vegetables; in addition, contrast-enhanced computed tomography detected microabscesses in a tractlike pattern in the liver. These findings led to an early diagnosis of fascioliasis, which was successfully treated without sequelae. In any patient with a history of consuming raw vegetables, fascioliasis should be suspected regardless of where the patient has lived.

scholarly journals Pulmonary Artery Intimal Sarcoma: A Case Report

2016 ◽  
Vol 9 (1) ◽  
pp. 267-272 ◽  
Author(s):  
Joseph P. Kriz ◽  
Nabil A. Munfakh ◽  
Gregory S. King ◽  
Juan O. Carden
Keyword(s):  
Pulmonary Artery ◽  
Malignant Tumors ◽  
Pulmonary Arteries ◽  
Vena Cava ◽  
Filling Defect ◽  
Intimal Sarcoma ◽  
Right Pulmonary Artery ◽  
Pulmonary Arterial ◽  
Left And Right ◽  
The Right

Pulmonary artery intimal sarcomas are rare and lethal malignant tumors that typically affect larger vessels: the aorta, inferior vena cava, and pulmonary arteries. Since symptoms and imaging of pulmonary arterial intimal sarcomas mimic pulmonary thromboembolism, the differential diagnosis of a patient presenting with chest pain, dyspnea, and filling defect within the pulmonary arteries should include intimal sarcoma. Often right ventricular failure is observed due to pulmonary hypertension caused by the obstructive effect of the tumor and concomitant chronic thromboembolism. We report the case of a 72-year-old African-American male with arterial intimal sarcoma of the left and right pulmonary artery with extension through the right artery into the bronchus and right lung.

Clinical picture and risk factors of occurrence of pulmonary artery thromboembolism

2021 ◽  
pp. 34-38
Author(s):  
Roman Petrovich Stepchenkov
Keyword(s):  
Pulmonary Artery ◽  
Pulmonary Thromboembolism ◽  
Correct Diagnosis ◽  
Vascular Wall ◽  
Fat Embolism ◽  
Shortness Of Breath ◽  
Sharp Pain ◽  
Threatening Condition ◽  
Life Threatening ◽  
The Right

Pulmonary artery thromboembolism (PATE) is a life-threatening condition in which the pulmonary artery or its branches are occluded by a detached thrombus (embolus). In this case, a thrombus can form both on the walls of blood vessels and directly in the right ventricle or atrium; in some cases, air or fat embolism may occur. The most common cause of pulmonary thromboembolism are thrombi that appear in the vessels of the lower extremities and migrate upward; a particular danger are floating thrombi, which attach to the vascular wall with one «leg» and can easily come off when coughing or exercising. Pulmonary embolism occurs in 1 case per 1000 patients, is observed mainly in adults and has a high mortality rate. There are no specific signs, characteristic of this particular pathology. Patients may have a sharp pain behind the sternum of a pleuritic nature, sudden shortness of breath, tachycardia, sometimes a cough with hemoptysis; precollaptoid state or even loss of consciousness may occur. Correct diagnosis is of utmost importance for the timely provision of emergency care. To make a diagnosis, pulse oximetry, chest radiography, CT angiography, and duplex or triplex angioscanning are used. In case of untimely provision of medical care, mortality in this condition can reach 50 %.

Dual-source CT in Diagnosis of Coronary Artery Fistula and its Value

2020 ◽  
Author(s):  
Cheng WANG ◽  
Yaying LI ◽  
Jiangyong LIU
Keyword(s):  
Coronary Artery ◽  
Pulmonary Artery ◽  
Correct Diagnosis ◽  
Main Pulmonary Artery ◽  
Image Data ◽  
Coronary Artery Fistula ◽  
Coronary Fistula ◽  
Detection And Diagnosis ◽  
The Right ◽  
Pulmonary Artery Fistula

Abstract Background: Coronary artery fistula refers to the symptom that the coronary artery trunk or branch connects with the heart cavity or the pulmonary circulation blood vessels in a congenital or an acquired manner. As early detection and diagnosis of CAF was necessary for the prevention and management of late symptoms and complications, we are supposed to master the imaging performance of CAFs so as to make a correct diagnosis. This paper seeks to investigate the imaging manifestations and application value of CT diagnosis of coronary fistula and its application value. Methods: To retrospectively analyze the clinical data and DSCT image data of 62 patients with coronary fistula, and summarize, analyze and summarize their image manifestations and types.Results: 62 CAFs originate from 58 LCA vessels, 32 RCA vessels. The distribution frequency of drainage site from high to low was as follows: 40 cases (63%) of the main pulmonary artery, 10 cases (16%) of the right atrium, 7 cases (11%) of the right ventricle, 3 cases (5%) of the left ventricle, 1 case (2%) of the left atrium, and 1 case of coronary sinus (2%), 1 case of the right lower pulmonary vein (2%). There were 39 cases (63%) of single fistula vessel, and 23 cases (37%) of multiple fistula vessel, including 21 cases of left and right coronary arteries. Coronary artery-pulmonary fistulae were the most common with a total of 40 cases. Conclusion: The popularization of CT improved the detection rate of CAFs. Coronary pulmonary-artery fistula was probably the most common seen type of CAFs. ECG-gating coronary artery CTA can accurately assess the origin of CAFs, the course of fistula vessels, and the drainage site, thereby providing important information for clinicians to treat coronary fistula.Trial registration: retrospectively registered

scholarly journals Orthodontic Treatment Including Autotransplantation of a Mature Tooth

2009 ◽  
Vol 79 (2) ◽  
pp. 387-393 ◽  
Author(s):  
Kazuaki Nishimura ◽  
Shinobu Amano ◽  
Kimihisa Nakao ◽  
Shigemi Goto
Keyword(s):  
Orthodontic Treatment ◽  
Tooth Movement ◽  
Root Resorption ◽  
Treatment Plan ◽  
Primary School Student ◽  
Appropriate Treatment ◽  
Japanese Female ◽  
Old Japanese ◽  
Chief Complaints

Abstract The patient was a 24-year-old Japanese female. The chief complaints were crowding and masticatory dysfunction due to the missing right first molar. Her maxillary first premolars had been extracted when she was a primary school student. We planned orthodontic treatment with extraction of the mandibular first premolars and transplantation of the mandibular left first premolar into the maxillary right first molar area. We made a diagnostic setup model to initiate an appropriate treatment plan for the discrepancy in tooth size ratio. Following the diagnostic setup model, the space in the maxillary right first molar area was closed by a small amount of tooth movement, and a good occlusion was achieved. The patient had been in retention for 7 years, and the occlusion has been maintained very well during this time. In the follow-up, 10 years after autotransplantation, no signs of inflammatory or replacement root resorption were found, and marginal bone support appeared similar to that of neighboring teeth.

scholarly journals Pulmonary hypertension associated with idiopathic pulmonary fibrosis: morphofunctional characteristics of pulmonary artery branches and their relationship with functional cardiorespiratory status

2007 ◽  
pp. 23-28
Author(s):  
G. V. Nekludova ◽  
A. L. Nekludova ◽  
A. V. Chernyak ◽  
S. N. Avdeev ◽  
Zh. K. Naumenko ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Idiopathic Pulmonary Fibrosis ◽  
Pulmonary Fibrosis ◽  
Pulmonary Artery ◽  
Sectional Area ◽  
Diffusing Capacity ◽  
Cardiorespiratory System ◽  
Cross Sectional ◽  
Vessel Lumen ◽  
The Right

The aim of the study was to investigate functional status of cardiorespiratory system and post-mortem morphometric characteristics of the heart and the lung arteries in secondary pulmonary hypertension (PH) associated with idiopathic pulmonary fibrosis (IPF). A retrospective analysis of functional status of cardiorespiratory system in 10 died patients with IPF (5 males and 5 females, the average age, 63.1 ± 9.2 yrs) was performed. During the last 6 months of their life, all the patients were investigated using body plethysmography, lung diffusing capacity test, arterial blood gas analysis and Doppler echocardiography measuring maximal systolic pulmonary artery (PA) pressure (sysPAP). We also performed histological examination of autopsy samples and morphometric examination of the PA and the heart. Severe restrictive disorders, significant decrease in the lung diffusing capacity with alveolo-capillary block and arterial hypoxemia have been found. The sysPAP was 44.9 ± 17.4 mm Hg in average. Microscopic lung tissue disorders were characteristic for usual interstitial pneumonia. Diameter of the pulmonary vessel lumen in IPF patients was 1.5-fold less and the vessel area was 1.7-fold less than those in controls. In IPF patients, the PA branch wall was 2.9-fold thicker, the proportion of the muscle area was 2.2-fold more and that of the intima area was 4.1-fold more than those in controls. Correlations were found between sysPAP and the cross-sectional area f the PA small branches (r = 0.71; p < 0.05), sysPAP and the proportion of intima area (r = 0.68, p < 0.05). Lumen diameter of the PA small branches correlated with the right atrium length (r = –0.81; p < 0.05) and the right ventricle mass correlated with diameter (r = –0.71; p < 0.05) and the cross-sectional area of the PA small branches (r = –0.75; p < 0.05). Significant correlations were also found between lung function, lung diffusing capacity and function signs of PH. Therefore, secondary PH in IPF is characterized by wall remodeling in the PA branches, mainly due to changes of intima. The 1.5-fold reduction of the vessel lumen is thought to be a cause of moderate growth of sysPAP followed by occurrence of cor pulmonale.

scholarly journals Pulmonary Artery Intimal Sarcoma Diagnosed Preoperatively by Endovascular Biopsy and Treated via Right Pneumonectomy and Pulmonary Arterioplasty

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Daiki Kato ◽  
Shohei Mori ◽  
Eriko Harada ◽  
Rintaro Shigemori ◽  
Takamasa Shibazaki ◽  
...  
Keyword(s):  
Pulmonary Artery ◽  
Preoperative Diagnosis ◽  
Pulmonary Thromboembolism ◽  
Main Pulmonary Artery ◽  
Anticoagulation Therapy ◽  
Treatment Strategies ◽  
Pulmonary Artery Sarcoma ◽  
Intimal Sarcoma ◽  
Planning Treatment ◽  
The Right

Introduction. Intimal sarcoma is a very rare tumor arising within the intima of the pulmonary artery. Preoperative diagnosis of pulmonary artery sarcoma is difficult, and the tumor is sometimes misdiagnosed as pulmonary thromboembolism. We report a case of pulmonary artery intimal sarcoma successfully diagnosed by preoperative endovascular biopsy and treated via right pneumonectomy and pulmonary arterioplasty. Presentation of a Case. A 72-year-old woman was referred to our hospital with a low-attenuation defect in the lumen of the right main pulmonary artery by computed tomography. Pulmonary artery thromboembolism was suspected, and anticoagulation therapy was administered. However, the defect in the pulmonary artery did not improve. Endovascular catheter aspiration biopsy was performed. Histological examination revealed pulmonary artery sarcoma. The patient was treated with right pneumonectomy and arterioplasty with the use of cardiopulmonary bypass. Discussion. Preoperative biopsy by endovascular catheter is worth considering for a patient with a tumor in the pulmonary artery and can help in planning treatment strategies.

scholarly journals Huge Retroperitoneal Dermoid: A Presentation

2019 ◽  
Vol 05 (04) ◽  
pp. e142-e145
Author(s):  
Tanweerul Huda ◽  
Mahendra Pratap Singh
Keyword(s):  
Histopathological Examination ◽  
Cystic Teratoma ◽  
Exploratory Laparotomy ◽  
Cystic Mass ◽  
Contrast Enhanced ◽  
Chief Complaints ◽  
Region Contrast ◽  
The Right ◽  
Enhanced Computed Tomography ◽  
Upper Abdomen

AbstractTeratoma can be defined as a true neoplasm that contains tissues that either are foreign to the primary site of origin or are histologically diverse and represent more than one of the embryonic germ layers. A 20-year-old female patient presented with chief complaints of swelling in the right upper abdomen since childhood and back pain for the past 4 years. Per abdomen, examination revealed a lump of around 15 cm in size in the right hypochondrial region extending to the epigastric region. Contrast-enhanced computed tomography abdomen revealed a 14.3 × 14.1 × 17.4 cm well-defined heterogeneously hypoattenuating nonenhancing complex cystic mass with focal areas of calcifications and fat attenuation in retroperitoneum. The patient was taken up for exploratory laparotomy and a tumor was found in the retroperitoneum, retrocavally and was excised with due care. Histopathological examination features were suggestive of mature cystic teratoma. The postoperative stay was uneventful.

scholarly journals Asymptomatic Pulmonary Artery Intimal Sarcoma with Chest Wall Metastasis as an Initial Manifestation: An Autopsy Case

2018 ◽  
Vol 2018 ◽  
pp. 1-5
Author(s):  
Tomoo Kakimoto ◽  
Mamoru Sasaki ◽  
Shojiroh Morinaga ◽  
Robert Nakayama ◽  
Naoto Minematsu
Keyword(s):  
Pulmonary Artery ◽  
Chest Wall ◽  
Chest Radiography ◽  
Chest Wall Tumor ◽  
Intimal Sarcoma ◽  
Abnormal Shadow ◽  
Initial Symptoms ◽  
Right Pulmonary Artery ◽  
The Right ◽  
Wall Tumor

Pulmonary artery intimal sarcoma (PAIS) is a rare mesenchymal malignancy arising in the pulmonary trunk or proximal pulmonary artery and shows intraluminal growth. Clinical manifestations in PAIS are predominantly related to the pulmonary artery embolism, so cases with initial symptoms related to an extrapulmonary metastasis are unusual. The present report describes an 82-year-old man without any cardiopulmonary symptoms who was detected with an abnormal shadow on chest radiography during a routine health checkup. Contrast medium-enhanced chest computed tomography revealed an enhancing mass in the right pulmonary artery, pulmonary nodules, and a chest wall tumor corresponding to the abnormal shadow observed using chest radiography. A core needle biopsy for the chest wall tumor determined a pathological diagnosis of unclassified sarcoma. The patient was diagnosed with PAIS on the basis of clinical, radiological, and pathological correlations. He was scheduled to receive supportive care, but died of respiratory failure 1 year from the first visit. An autopsy revealed the pleomorphic sarcoma occupying the entire lumen of the right pulmonary artery with the only site of extrapulmonary metastasis in the chest wall. We should be aware of rare cases of asymptomatic PAIS found through routine health checkups.

scholarly journals Laparoscopic Repair of Right Paraduodenal Hernia in Adult Patients: Case Report and Literature Review

2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Tomoko Takagishi ◽  
Yuta Niimi ◽  
Goshi Matsuki ◽  
Shinta Nagano ◽  
Junsuke Hinami ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Laparoscopic Repair ◽  
Paraduodenal Hernia ◽  
Excessive Drinking ◽  
Japanese Female ◽  
Old Japanese ◽  
Right Paraduodenal Hernia ◽  
Sufficient Degree ◽  
The Right ◽  
Hernia Orifice

A 56-year-old Japanese female presented with vomiting, nausea, and abdominal pain after excessive drinking and eating. Abdominal computed tomography showed an encapsulated circumscribed cluster of jejunal loops in the right upper quadrant. She was diagnosed with a strangulated intestinal obstruction caused by right paraduodenal hernia (PDH) and underwent an emergency laparoscopic repair. A view through the endoscope showed the right PDH, which was encapsulated under the mesocolon. Most of the small bowel was entrapped and adhered inside the sac, requiring careful adhesiolysis. The hernia orifice was expanded to a sufficient degree, and the strangulation was relieved, avoiding the need of resecting the small intestine. Recovery was uneventful, and the patient remains free of symptoms 3 years after surgery. Findings in a total of 29 patients (including this report) who underwent laparoscopic repair of right or left PDHs in Japan are discussed.

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