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

WEGENER GRANULOMATOSIS- CASE REPORT

Wegener granulomatosis is uncommon multisystemic disease, characterized by necrotizing granulomatous inflammation of the upper and lower respiratory tracts and general focal necrotizing vasculitis (Commonly known as „Wegener's triad“). The lungs are involved in 72 per cent of patients and the clinic and radiographic findings indicated bilateral pulmonary nodules of varying size and definition, cavitated in half of the patients, accompanied by the nodular lesion with a rare involvement of the pleura.We described a case of 62-year-old women with pansinusitis, mild azotemia and initial respiratory tract symptoms such as chronic cough and occasional hemoptysis. Due to bilateral nodular infiltrates in lungs on chest radiogram she was initially treated for smear negative pulmonary tuberculosis, but without expected antituberculous response. An additional diagnostic procedure pointed to Morbus Wegener.Two patterns of ANCA positive immunofluorescence are recognized as reliable and valuable diagnostic tools in the absence of histopathology for the diagnosis of Wegener granulomatosis