Difficulties in establishing a timely diagnosis of pulmonary artery sarcoma misdiagnosed as chronic thrombo-embolic pulmonary disease: a case report

<p>Abstract</p> <p>Introduction</p> <p>Pulmonary artery sarcomas are rare neoplasms that are often confused with chronic thrombo-embolic disease, as both can have similar clinical and imaging presentation.</p> <p>Case presentation</p> <p>In this report, we present a case of a 50-year-old man initially diagnosed with chronic thrombo-embolic pulmonary disease, but who was later found to have pulmonary artery sarcoma with poor survival prognosis. We review the clinical and imaging characteristics of the two diseases and discuss the difficulties in establishing a timely diagnosis.</p> <p>Conclusion</p> <p>Similar clinical features and imaging presentation of pulmonary artery sarcoma and chronic thrombo-embolic pulmonary disease make definitive diagnosis difficult. This case report also illustrates and emphasizes that in any case with no predisposition factors for embolism, no evidence of deep venous thrombosis and pulmonary emboli, and inadequate relief of symptoms with anticoagulation, an alternative diagnosis of pulmonary artery sarcoma should be considered. If pulmonary artery sarcoma is diagnosed late in the course of the disease, there is usually a poor survival outcome.</p

Twenty-first-century International Political Economy: a class-relational perspective

The nature, subject matter and future direction of International Political Economy has been opened up for debate following interventions by Benjamin Cohen, John Hobson and special issues of the Review of International Political Economy and New Political Economy. Most contributors to the debate are dissatisfied with the current state of International Political Economy and desire to identify the ‘Big Questions’ of the 21st century. This article argues, however, that all contributors miss the ‘Really Big Question’ of the 21st century: the rise of a planetary labouring class of over 3 billion (and counting), living, for the most part, in poverty or near-poverty. While this class’s existence is not new (although its size is), International Political Economy’s ignorance of it is as old as the discipline’s institutional formation. This article shows that mainstream International Political Economy’s sidelining of class relations disables it from explaining the global systemic transformations that underpin changes in the relations between states and markets (International Political Economy’s traditional focus). It illustrates the long-term making of the global labouring class by discussing three examples of global systemic transformation: the rise of capitalism; the post-1945 embedded liberalism–development project conjuncture; and contemporary globalisation