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Angiosarcoma in the chest: radiologic – pathologic correlation

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ABSTRACT

Rationale:: Angiosarcomas are rare, malignant vascular tumors.

Patient concerns:: They represents about 2% of all soft tissue sarcoma, which can often metastasize through the hematogenous route. The radiological features have been analyzed in 4 patients with metastatic angiosarcoma in the chest.

Diagnoses:: The main radiologic findings included nodules, cysts, nodules with halo sign, and vascular tree-in-bud. Morphologic features, as observed in the histologic specimen, have been correlated with radiologic appearance.

Lessons:: Metastatic angiosarcomas to the lung are characterized by a wide variety of radiologic appearances that can be very characteristic. Computed tomographic findings observed include bilateral solid nodules, cystic, and bullous lesions sometimes associated with spontaneous hemopneumothoraces.

No MeSH data available.


Related in: MedlinePlus

Patient 4. Comparison between baseline CT scan and control 3 weeks later shows that the cystic lesions are bigger and more numerous than the prior, suggesting a rapid disease progression. Moreover, nodules that were visible in the prior examination now have a cystic shape (blue circle). Informed consent from patients was obtained.
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Figure 12: Patient 4. Comparison between baseline CT scan and control 3 weeks later shows that the cystic lesions are bigger and more numerous than the prior, suggesting a rapid disease progression. Moreover, nodules that were visible in the prior examination now have a cystic shape (blue circle). Informed consent from patients was obtained.

Mentions: CT scan of the chest showed bilateral hydropneumothorax with a large pleural effusion on the left side and smaller one on the right side. Furthermore, several cystic lesions (measuring from 9 to 24 mm in size) and solid nodules (from 8 to 20 mm) were present in the lungs bilaterally, suspicious of metastatic lesions (Fig. 10). The patient had a bilateral pleural drainage showing hemorrhagic fluid. His respiratory deterioration continued and he developed worsening subcutaneous emphysema. CT scan confirmed widespread subcutaneous emphysema and associated pneumomediastinum (Fig. 11). Three weeks later, the patient had partial resolution of the hydropneumothorax and pneumomediastum, and some of the pulmonary pre-existent nodules had become cystic and the pre-existing cysts were bigger (Fig. 12). The patient died 2 months later of progressive disease.


Angiosarcoma in the chest: radiologic – pathologic correlation
Patient 4. Comparison between baseline CT scan and control 3 weeks later shows that the cystic lesions are bigger and more numerous than the prior, suggesting a rapid disease progression. Moreover, nodules that were visible in the prior examination now have a cystic shape (blue circle). Informed consent from patients was obtained.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5134813&req=5

Figure 12: Patient 4. Comparison between baseline CT scan and control 3 weeks later shows that the cystic lesions are bigger and more numerous than the prior, suggesting a rapid disease progression. Moreover, nodules that were visible in the prior examination now have a cystic shape (blue circle). Informed consent from patients was obtained.
Mentions: CT scan of the chest showed bilateral hydropneumothorax with a large pleural effusion on the left side and smaller one on the right side. Furthermore, several cystic lesions (measuring from 9 to 24 mm in size) and solid nodules (from 8 to 20 mm) were present in the lungs bilaterally, suspicious of metastatic lesions (Fig. 10). The patient had a bilateral pleural drainage showing hemorrhagic fluid. His respiratory deterioration continued and he developed worsening subcutaneous emphysema. CT scan confirmed widespread subcutaneous emphysema and associated pneumomediastinum (Fig. 11). Three weeks later, the patient had partial resolution of the hydropneumothorax and pneumomediastum, and some of the pulmonary pre-existent nodules had become cystic and the pre-existing cysts were bigger (Fig. 12). The patient died 2 months later of progressive disease.

View Article: PubMed Central - PubMed

ABSTRACT

Rationale:: Angiosarcomas are rare, malignant vascular tumors.

Patient concerns:: They represents about 2% of all soft tissue sarcoma, which can often metastasize through the hematogenous route. The radiological features have been analyzed in 4 patients with metastatic angiosarcoma in the chest.

Diagnoses:: The main radiologic findings included nodules, cysts, nodules with halo sign, and vascular tree-in-bud. Morphologic features, as observed in the histologic specimen, have been correlated with radiologic appearance.

Lessons:: Metastatic angiosarcomas to the lung are characterized by a wide variety of radiologic appearances that can be very characteristic. Computed tomographic findings observed include bilateral solid nodules, cystic, and bullous lesions sometimes associated with spontaneous hemopneumothoraces.

No MeSH data available.


Related in: MedlinePlus