{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T15:51:02Z","timestamp":1776095462698,"version":"3.50.1"},"reference-count":13,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T00:00:00Z","timestamp":1776038400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Pulmonary artery intimal sarcoma (PAIS) is a rare and aggressive malignancy that is frequently misdiagnosed as pulmonary thromboembolic disease because of overlapping clinical and imaging features.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>A 52-year-old woman was admitted in September 2025 due to progressive dyspnea, pleural effusion, and elevated D-dimer levels. Imaging analysis suggested potential pulmonary embolism, and thoracoscopic pleural biopsy and endovascular sampling revealed no evidence of malignancy. The persistent obstruction of the pulmonary artery, the absence of an identifiable thromboembolic source, and atypical angiographic findings raised the suspicion of an underlying malignant process. A repeat pulmonary angiography, accompanied by targeted endovascular biopsy, identified a spindle cell tumor with myxoid degeneration. Immunohistochemical and molecular analyses corroborated the diagnosis of PAIS. She experienced temporary symptomatic improvement following interventional treatment and subsequently underwent surgical pulmonary artery tumor endarterectomy. The postoperative course was uneventful.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This case highlights the diagnostic challenges associated with PAIS and underscores the importance of considering PAIS in the differential diagnosis of pulmonary thromboembolic disease, particularly in patients with atypical pulmonary artery lesions and inconclusive initial investigations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1783394","type":"journal-article","created":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T15:01:12Z","timestamp":1776092472000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Pulmonary artery intimal sarcoma with pleural effusion: a case report"],"prefix":"10.3389","volume":"13","author":[{"given":"Xian-Ying","family":"Xie","sequence":"first","affiliation":[{"name":"School of Medicine, Wuhan University of Science and Technology, Wuhan","place":["Hubei, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xue-Jiao","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science","place":["Xiangyang, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E.","family":"Guo","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science","place":["Xiangyang, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yu-Lan","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science","place":["Xiangyang, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,4,13]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"787","DOI":"10.1093\/ejcts\/ezs387","article-title":"Retrospective institutional study of 31 patients treated for pulmonary artery sarcoma.","volume":"43","author":"Mussot","year":"2013","journal-title":"Eur J Cardio-Thoracic Surg."},{"key":"B2","doi-asserted-by":"publisher","first-page":"102889","DOI":"10.1016\/j.critrevonc.2020.102889","article-title":"A comprehensive review on the diagnosis and management of intimal sarcoma of the pulmonary artery.","volume":"147","author":"Assi","year":"2020","journal-title":"Crit Rev Oncol Hematol."},{"key":"B3","doi-asserted-by":"publisher","first-page":"977","DOI":"10.1016\/j.athoracsur.2008.08.018","article-title":"Management of primary pulmonary artery sarcomas.","volume":"87","author":"Blackmon","year":"2009","journal-title":"Annals Thoracic Surg."},{"key":"B4","doi-asserted-by":"publisher","first-page":"725","DOI":"10.1007\/s00066-024-02250-6","article-title":"Pulmonary artery intimal sarcoma: case report of a patient managed with multimodality treatment and a comprehensive literature review.","volume":"200","author":"Atahan","year":"2024","journal-title":"Strahlentherapie Onkol."},{"key":"B5","doi-asserted-by":"publisher","first-page":"005150","DOI":"10.12890\/2025_005150","article-title":"Pulmonary artery intimal sarcoma mimics recurrent pulmonary artery embolism.","volume":"12","author":"Ioakeimidou","year":"2025","journal-title":"Eur J Case Reports Internal Med."},{"key":"B6","doi-asserted-by":"publisher","first-page":"658","DOI":"10.6515\/acs.202307_39(4).20230306c","article-title":"Endovascular biopsy for pulmonary artery sarcoma mimicking pulmonary embolism.","volume":"39","author":"Yeh","year":"2023","journal-title":"Acta Cardiol Sinica."},{"key":"B7","doi-asserted-by":"publisher","first-page":"792","DOI":"10.3348\/kjr.2018.19.4.792","article-title":"Pulmonary artery intimal sarcoma versus pulmonary artery thromboembolism: Ct and clinical findings.","volume":"19","author":"Kim","year":"2018","journal-title":"Korean J Radiol."},{"key":"B8","doi-asserted-by":"publisher","first-page":"e24699","DOI":"10.1097\/md.0000000000024699","article-title":"Pulmonary artery intimal sarcoma mimicking pulmonary thromboembolism: a case report.","volume":"100","author":"Li","year":"2021","journal-title":"Medicine."},{"key":"B9","doi-asserted-by":"publisher","first-page":"671","DOI":"10.1007\/s12149-009-0292-y","article-title":"Diagnostic usefulness of 18f-Fdg Pet\/Ct in the differentiation of pulmonary artery sarcoma and pulmonary embolism.","volume":"23","author":"Ito","year":"2009","journal-title":"Ann Nuclear Med."},{"key":"B10","doi-asserted-by":"publisher","first-page":"1761","DOI":"10.1002\/1097-0142(19930301)71:53.0.co;2-7","article-title":"Sarcomas of the great vessels. 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