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CT Findings of Pulmonary Metastases from Primary Cardiac Angiosarcoma

[ Vol. 17 , Issue. 10 ]

Author(s):

Yan Chen, Xiang He, Jianfeng Shang, Nan Zhang, Xiaodan Li, Jiayi Liu, Lei Xu, Dongting Liu, Yu Li, Zhonghua Sun* and Zhaoying Wen   Pages 1216 - 1220 ( 5 )

Abstract:


Background: Primary cardiac angiosarcoma is a rare malignancy with high predilection to involve surrounding structures such as pulmonary metastases. We analysed the chest computed tomography (CT) imaging features of patients diagnosed with primary cardiac angiosarcoma with pulmonary metastases in this study.

Methods: This study retrospectively reviewed 12 patients with confirmed primary cardiac angiosarcoma, out of which eight (all men) with pulmonary metastasis were included in the analysis. The patients’ age ranged from 17 to 74 (mean: 48) years. CT was performed in all patients with unenhanced, contrast-enhanced, and both scans were done in 1, 3 and 4 patients, respectively.

Results: Nodular lesions were observed in 7 patients with multiple solid nodules observed in 6 out of 7 patients. A solitary solid nodule was found in the remaining patient in the upper lobe and apical segment of the right lung with a diameter of 11.7 mm. All solid nodules were distributed along with bronchovascular bundles in the lungs, and their maximum diameter ranged from 2.3 to 19.9 mm. Nodules larger than 10 mm in diameter were heterogeneously enhanced on contrast-enhanced CT images (5/8 patients), whereas those smaller than 10 mm were homogeneously enhanced (3/8 patients). Other imaging features, namely the tree-in-bud pattern, emphysema, pleural effusion, and mediastinal lymph node enlargement, were observed in 4, 3, 3, and 2 patients, respectively.

Conclusion: CT enhancement features of pulmonary metastasis in patients with primary cardiac angiosarcoma depend on the size of pulmonary nodules, with larger ones being heterogeneous and smaller ones homogeneous. Other signs are less noticed.

Keywords:

Angiosarcoma, chest, computed tomography, nodules, heart, Primary cardiac angiosarcoma (PCAS).

Affiliation:

Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, Department of Diagnostic CT, Cangzhou Central Hospital, No. 16, Xinhua Road, Cangzhou 061001, Hebei, Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, Discipline of Medical Radiation Science, Curtin Medical School, Curtin University, Perth, Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing

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