57 Filling Defect in Pulmonary Artery on Computed Tomography

CLINICAL IMAGAGINGAN ATLAS OF DIFFERENTIAL DAIGNOSIS

EISENBERG

DR. Muhammad Bin Zulfiqar PGR-FCPS III SIMS/SHL

• Fig C 57-1 Acute pulmonary embolus. CT pulmonary angiogram demonstrates a large filling defect within the right main and left interlobar pulmonary arteries.113

• Fig C 57-2 Chronic pulmonary embolus. An eccentrically located thrombus forms obtuse angles with the vessel wall (arrows). Note the dilated collateral bronchial artery (arrowhead).113

• Fig C 57-3 Chronic pulmonary embolus. Extensive collateral bronchial arteries (arrows) associated with the large embolus in the main and left pulmonary arteries (arrowhead).113

• Fig C 57-4 Lung algorithm artifact mimicking pulmonary embolus. Bright rings around normal pulmonary arteries (arrows) produce an appearance mimicking multiple pulmonary emboli.113

• Fig C 57-5 Mucous plugs. Filling defects (arrows) that mimic acute pulmonary emboli. The posterobasal segment of the right lower lobe bronchus is dilated as well as filled with mucus. Identification of the normal accompanying pulmonary arteries (arrowheads) allows the correct interpretation of this finding.133

• Fig C 57-6 Pulmonary artery stump. In situ thrombosis in the right pulmonary artery stump of an elderly man who had undergone a previous right pneumonectomy for lung cancer.113

• Fig C 57-7 Pulmonary artery sarcoma. Contrast scan shows a heterogeneously enhancing, lobulated mass within the main pulmonary artery (arrow). A metastatic deposit is noted within the right pulmonary artery (arrowhead).113

• Fig C 57-8 Pulmonary artery leiomyosarcoma. Contrast scan shows a homogeneous mass that fills the left main pulmonary artery and extends into the left upper and lower lobe pulmonary arteries (arrows).114

• Fig C 57-9 Tumor embolus. Large tumor embolus within the right lower lobe pulmonary artery (artery) from a primary endometrial stromal sarcoma that had invaded the inferior vena cava.113