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Unilateral Absence of Pulmonary Perfusion Mimicking Pulmonary Embolism

Bernard Chow1,2, Conrad Wittram3 and Victor W. Lee4

1 Department of Radiology, MetroWest Medical Center, Framingham Union Hospital, Framingham, MA 01701.
2 Present address: Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St., Boston, MA 02115.
3 Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St., Boston, MA 02114.
4 Department of Radiology, Boston Medical Center, Boston University, 88 E. Newton St., Boston, MA 02118.



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  		Fig. 1A. —69-year-old woman with pleuritic chest pain and dyspnea. Composite image from posterior projection of ventilation-perfusion scan was obtained with technetium-99m diethylenetriamine pentaacetic acid aerosol (left) and technetium-99m macroaggregated albumin (right). Absence of left pulmonary perfusion is noted when lungs are normally ventilated.

 


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  		Fig. 1B. —69-year-old woman with pleuritic chest pain and dyspnea. Contrast-enhanced CT scan shows filling defect of main and left pulmonary artery with expansion and slight enhancement.

 


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  		Fig. 1C. —69-year-old woman with pleuritic chest pain and dyspnea. Pulmonary arteriogram shows occluding intraluminal mass extending from pulmonary trunk to left pulmonary artery.

 


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  		Fig. 1D. —69-year-old woman with pleuritic chest pain and dyspnea. Photograph of main pulmonary artery reveals tumor (arrow).

 


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  		Fig. 1E. —69-year-old woman with pleuritic chest pain and dyspnea. Photomicrograph of pulmonary artery shows extensive spindle-cell proliferation with abundant mitoses. (H and E, x10)

 

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