Infectious causes of pulmonary artery invasion are extremely rare. A 71-year-old man had history of progressive dyspnea with abnormal salty taste. Contrast CT showed a filling defect mass in the main pulmonary artery with extraluminal extension to the heart and mediastinum. FDG PET/CT revealed a mass lesion with intense FDG uptake in the main pulmonary artery and peripheral. There were lesions with intense FDG uptake in the middle mediastinum besides the ascending aorta. Malignant tumor was suspected. Later, he received tumor debulking excision. Pathology reports showed necrotizing granulomatous inflammation, positive interferon-gamma release assays, and positive Mycobacterium tuberculosis culture.
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