A 48-year-old woman with a history of sternal chondrosarcoma that had been completely resected 3 years previously presented with a 7-month history of cough and progressive dyspnoea. On admission she had blood oxygen saturation of 88%. Pulmonary CT angiography showed a large tumour embolus in the main pulmonary artery bifurcation that extended into the left pulmonary artery and all the left lobar and segmental arterial branches and caused a large left lower lobe parenchymal consolidation (figure). Percutaneous transthoracic biopsy of the consolidation showed metastatic chondrosarcoma. She underwent a left pneumonectomy. Macroscopic examination of the resected lung (figure) showed a translucent myxoid tissue filling the pulmonary arteries in an arboreous pattern. Microscopic analysis confirmed that the metastatic chondrosarcoma was confined to the vasculature, even inside the parenchymal consolidation. The patient died 4 months later from respiratory insufficiency from right-sided pleural and pulmonary infection associated with rapid metastatic spread to the right lung.
展开▼
