IMAGES IN THORAX

A suspicious clot

P Lee¹, F-K Cheah², J Huang², D Poon³, C-M Loo¹

¹ Department of Respiratory and Critical Care Medicine, Singapore General Hospital, Singapore
² Department of Diagnostic Radiology, Singapore General Hospital, Singapore
³ Medical Oncology, National Cancer Centre, Singapore

Correspondence to:
^{Correspondence to} Dr P Lee, Department of Respiratory and Critical Care Medicine, Singapore General Hospital, Outram Road, Singapore 169608; lee.pyng@sgh.com.sg

Accepted 21 January 2009

The first 150 words of the full text of this article appear below.

A 72-year-old man presented with right-sided pleuritic chest pain, chronic cough and weight loss. Chest x ray revealed a moderate sized pleural effusion. Chest CT showed thromboembolism of the right main pulmonary artery, and pleural effusion with compression atelactasis of the right lower lobe of the lung (fig 1). As the thrombus appeared suspicious, being unilateral, central and occupying the entire lumen of the pulmonary artery without abnormality in the contralateral lung, magnetic resonance arteriography was performed which showed heterogeneous enhancement (fig 2). Positron emission tomography (PET)/CT confirmed increased [¹⁸F]fluorodeoxyglucose (FDG) uptake by the mass in the right main pulmonary artery, pleura, right clavicle, L1 vertebral body and both adrenal glands (fig 3). He underwent CT-guided biopsy of the L1 vertebral body, and histology was compatible with intimal sarcoma of the pulmonary artery. He was treated with gemcitabine but developed acute dyspnoea with . . . [Full text of this article]

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