Pulmonary artery intimal sarcoma diagnosed using endobronchial ultrasound-guided transbronchial needle aspiration

Author:

Caraway Nancy P.1,Salina Davide2,Deavers Michael T.3,Morice Rodolfo4,Landon Gene1

Affiliation:

1. Address: Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030, USA

2. Department of Pathology, University of British Columbia, Royal Jubilee Hospital, Victoria, BC V8R 1J8, Canada

3. Department of Pathology and Immunology, The Houston Methodist Hospital, Weill Cornell Medical College, Houston, Texas 77030, USA

4. Department of Pulmonary Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030, USA

Abstract

Intimal sarcoma of the pulmonary artery is a rare intraluminal malignant neoplasm that has an aggressive biological behavior, and early diagnosis may improve patient outcome. We describe a case of pulmonary artery intimal sarcoma diagnosed on cytologic material obtained by endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) biopsy with rapid on-site evaluation (ROSE). The aspirate showed loosely cohesive clusters of pleomorphic malignant spindled and epithelioid cells. An immunostain panel did not demonstrate any definitive mesenchymal or epithelial differentiation. The tumor's intraluminal origin was supported by radiographic imaging studies. Subsequently, the patient received preoperative chemotherapy and underwent tumor resection with reconstruction. This report describes the cytomorphologic features of this rare intravascular tumor and demonstrates how EBUS-TBNA with ROSE was instrumental in obtaining optimal cytologic sampling for ancillary studies, thus expediting the management.

Publisher

Scientific Scholar

Subject

Pathology and Forensic Medicine

Reference14 articles.

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2. Pulmonary artery sarcomas. A review and report of a case;Baker;Arch Pathol Lab Med,1985

3. Pulmonary artery sarcoma: A histologic and follow-up study with emphasis on a subset of low-grade myofibroblastic sarcomas with a good long-term follow-up;Tavora,2008

4. Primary pulmonary artery sarcoma. Report of two autopsy cases studied by immunohistochemistry and electron microscopy, and review of 110 cases reported in the literature;Nonomura;Acta Pathol Jpn,1988

5. Pulmonary artery sarcoma: A clinicopathologic and immunohistochemical study of 12 cases;Huo;Am J Clin Pathol,2006

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