• J Martino, J Allende, A Herrero, E Colunga, L Martínez, C Escudero, and F Del Busto.
• Department of Emergency Medicine, Hospital Central de Asturias, Oviedo, Spain.
• Am J Emerg Med. 1994 Nov 1; 12 (6): 664-6.

AbstractPulmonary thromboembolism (PTE) is a disease whose diagnosis in the emergency department constitutes a challenge to the clinician. Perfusion lung scans have been important in helping in this context, mainly because of the fact that a normal perfusion lung scan rules out the presence of a clinically significant PTE. Nevertheless, false-positive results are sometimes observed, causing a diagnostic dilemma. An example is a case of bronchogenic carcinoma involving a pulmonary artery or its branches. In such patients, some characteristics of the scintigraphic imaging could guide the diagnosis toward a nonembolic origin of the perfusion defect. A case of small-cell carcinoma of the lung involving the left pulmonary artery whose clinical presentation suggested considering the possibility of PTE is reported. The so-called "stripe sign" is reviewed, and certain clues for the differential diagnosis of a massive and one-sided perfusion defect are discussed.

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