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The Expanding Horizons of Endobronchial UltrasoundMetastatic Pulmonary Artery Sarcoma: Diagnosis of a Tumor Embolism

Núria Chamorro, MD; Isabel Blanco, MD; Marcelo Sánchez, MD; Jose Ramírez, MD; Joan A. Barberà, MD; Carlos Agustí, MD
Author and Funding Information

From the Department of Pulmonary Medicine (Drs Chamorro, Blanco, Barberà, and Agustí), Institut Clínic del Tórax; the Department of Radiology (Dr Sánchez); and the Department of Pathology (Dr Ramírez), Centro de Diagnóstico Biomédico (CDB), Institut d’Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), University of Barcelona; and Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES) (Drs Ramírez, Barberà, and Agustí), Barcelona, Spain.

Correspondence to: Isabel Blanco, MD, Servei de Pneumologia, Institut Clínic del Tórax, Hospital Clínic, Villarroel 170, 08036 Barcelona, Spain; e-mail: iblanco2@clinic.ub.es


Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2012;142(5):1334-1336. doi:10.1378/chest.12-0181
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A 51-year-old woman was given a diagnosis of primary retroperitoneal synovial sarcoma, which was surgically removed, and she was subsequently treated with chemotherapy and radiotherapy. Five years later, the patient was readmitted with a 1-month history of progressive dyspnea and was initially given a diagnosis of bilateral pulmonary embolism. Angiography performed some time later revealed progression of the previous filling defects and the appearance of two new nodular endovascular images. Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) was performed, and the cytologic analysis of the cell aspirate was compatible with endovascular metastatic sarcoma. In conclusion, EBUS-TBNA in the appropriate setting is an effective method for sampling endovascular lesions, adding pathologic information and allowing for early and accurate diagnosis.

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