Fig. 11

Contrast-enhanced axial CT image (a) demonstrates a large filling defect in the left pulmonary artery (arrow). The lesion remained stable after a course of anticoagulation, which raised the suspicion for a malignancy. Subsequently obtained FDG-PET (b) demonstrated the central part of this filling defect to be hypermetabolic, consistent with a primary pulmonary artery sarcoma. Gadolinium-enhanced cardiac MR (c) performed 60 s post contrast for preoperative evaluation demonstrates a lesion in the left pulmonary artery with an non-enhancing central portion, consistent with a bland thrombus, and an enhancing component in the pulmonary arteries and left lower lobe, suggestive of a tumour