A 46-year-old man presented with 6 months of progressive exertional dyspnoea. Computed tomography pulmonary angiography showed severe bilateral stenoses of the left and right main pulmonary arteries (Panel A). Exploratory thoracotomy had been performed 2 months earlier for suspected pulmonary embolism, which revealed suspected pulmonary artery malignancy which could not be removed due to high risk of the anatomy. Positron emission tomography-computed tomography did not reveal any other locations suspicious for malignancy. After evaluation by a multidisciplinary team, percutaneous transluminal pulmonary artery biopsy (PTPB) was performed (Panels B and C and Supplementary material onlineSupplementary material online, Video S1) using a biopsy forceps (Panel D) and millet grain sized tissue samples obtained (Panel E). Haematoxylin and eosin staining and immunohistochemical staining were consistent with lymphomatoid granulomatosis (Panel F).

中文翻译：

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经皮腔内肺动脉活检。

一名46岁的男性表现为6个月的进行性劳累性呼吸困难。计算机断层扫描肺血管造影显示左右主肺动脉严重双侧狭窄（图A）。由于怀疑有肺栓塞，在2个月前进行了探索性开胸手术，这表明由于存在较高的解剖风险，疑似肺动脉恶性肿瘤无法切除。正电子发射断层扫描计算机断层扫描没有发现其他可疑恶性肿瘤的位置。在多学科团队评估后，使用活检钳（图D）进行了经皮腔内肺动脉穿刺活检（PTPB）（图B和C，在线补充材料，视频S1），并获得了小米颗粒大小的组织样本（图E）。 ）。