Pulmonary Vascular Disease: Pulmonary Vascular Disease: VTE |

Endovascular Catheter Guided Forceps Biopsy for the Diagnosis of Suspected Pulmonary Artery Sarcoma: A Preliminary Study of 8 Cases FREE TO VIEW

Wanmu Xie, MD; Yuanhua Yang; Zhenguo Zhai; Chen Wang
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China-Japan Friendship Hospital, Beijing, China

Copyright 2016, American College of Chest Physicians. All Rights Reserved.

Chest. 2016;149(4_S):A523. doi:10.1016/j.chest.2016.02.545
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SESSION TITLE: Pulmonary Vascular Disease: VTE

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Saturday, April 16, 2016 at 11:45 AM - 12:45 PM

PURPOSE: Pulmonary artery sarcoma (PAS) is a rare malignant tumour with a poor prognosis. Making a preoperative histopathological diagnosis is quite difficult. In this preliminary study, a new technique of endovascular catheter guided forceps biopsy (CGFB) was used to diagnose PAS.

METHODS: Between January 2012 and October 2014, 16 consecutive patients suspected with PAS were admitted in Beijing Chaoyang Hospital for further diagnosis. 8 of the patients agreed to perform CGFB after right-heart catheterization. Procedures of the CGFB were described as followings: Aguiding catheterwas advanced to the pulmonary artery with the help of wire. Catheter was put in close touch with angiographic “thrombus-like” substance. Forcep were inserted directly in touch with the mass, clamp the tissue quickly. The operation was repeated until the enough tissues were obtained. Hematoxylin-eosin staining and immunohistochemical staining of the specimen were carried out for evaluation.

RESULTS: Of the 8 patients agreed for CGFB, 3 were men and 5 were women. The mean age of the patients was 52.4 years (range, 32-75 years). The thrombus-like mass occluded the central pulmonary arteries in all of the 8 patients. 3 occluded the right pulmonary artery, 2 in the left pulmonary artery and 2 located both in the pulmonary artery trunk and right pulmonary artery. Lung involvement was also identified in 3 patients. All the 8 patients were performed CGFB successfully and tissue samples were gained for histological examination. PAS was confirmed in 5 patients. CTEPH was considered the correct diagnosis with the histological findings from CGFB and confirmed after pulmonary thrombendarterectomy. While in 2 patients there were only necrotic tissue and thrombus detected from the harvested sample, one of the patients was then confirmed PAS with CT guided percutaneous lung biopsy 4 months later. All the 8 patients tolerated the procedure well. No complications like bleeding, perforation, etc. during and after CGFB in 8 patients.

CONCLUSIONS: CGFB may be a safe, feasible and comparatively less invasive approach to the tissue diagnosis of suspected PAS preoperatively, although false negative results may exist.

CLINICAL IMPLICATIONS: A new technique of endovascular catheter guided forceps biopsy was tested for the diagnose PAS.

DISCLOSURE: The following authors have nothing to disclose: Wanmu Xie, Yuanhua Yang, Zhenguo Zhai, Chen Wang

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