title: Pulmonary artery leiomyosarcoma: an unusual cause of shortness of breath.
abstract: BACKGROUND
  Primary leiomyosarcomas of the pulmonary artery are very rare tumours with 30 cases reported in the English literature. Herein, we report the first case with evidence of a renal metastasis.
  
  
  METHODS
  The tumour was discovered at autopsy in a 61-year-old woman who had presented with shortness of breath and chest pain. It was located in the pulmonary trunk with extension into the adjacent pericardial cavity. Separate nodules were found in the pulmonary valve, the left pulmonary artery and the left kidney.
  
  
  RESULTS
  On microscopic examination, the tumour was composed of spindle cells with cigar-shaped nuclei immunoreactive for vimentin, desmin, CD68 and α-smooth muscle actin.
  
  
  CONCLUSIONS
  Primary pulmonary artery leiomyosarcoma is easily confused clinically with pulmonary thromboembolism and most cases are diagnosed post mortem. Most tumours arise in the pulmonary trunk and metastases are only rarely described. The management of patients with this rare tumour depends on early surgical resection and the prognosis is unfavourable.
authors.affiliation: Department of Medicine, University Hospital, Galway and National University of Ireland, Galway, Ireland. gerard.flaherty@nuigalway.ie
authors.forename: G
authors.initials: G
authors.lastname: Flaherty
authors.forename: P
authors.initials: P
authors.lastname: McCarthy
authors.forename: G
authors.initials: G
authors.lastname: Mortimer
mesh_terms: D001964:Bromhexine; D004417:Dyspnea / Q000209:etiology*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007680:Kidney Neoplasms / Q000556:secondary; D007890:Leiomyosarcoma / Q000150:complications* / Q000473:pathology / Q000556:secondary; D008875:Middle Aged; D011651:Pulmonary Artery / Q000000981:diagnostic imaging; D011859:Radiography; D019043:Vascular Neoplasms / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology
chemical_list: D001964:Bromhexine