[Medical Human Story – Episode 70] The Shadow of Death That Even AI Missed: The Final Truth of a Primary Pulmonary Artery Sarcoma Misdiagnosed as Pulmonary Embolism-1

 

"It was never a blood clot. It was a silent tumor, feeding on the remaining time of a man’s life."

 

Epilogue:

 

In the heart of the city, 2:17 AM in late autumn is when the world is plunged into its deepest sleep. Yet, the university hospital emergency room defied this silence, transforming into a fierce battlefield where life and death collided.

A stretcher burst through the automatic doors, carrying a man fighting for his life. Kim Jung-ho, 64. He wasn’t just breathing; he was wringing out his lungs like an old, failing engine, gasping in a final cry for survival. The sound of his labored breathing—"huff... huff..."—so heavy it seemed a struggle even to produce, shattered the quiet.

"Sir, stay with me! Can you hear me?" Despite the urgent shouts of Dr. Park Ji-hoon, an emergency medicine specialist, Mr. Kim’s consciousness was fading. His oxygen saturation, displayed on the monitor, sat at 81%—a level far beyond the threshold of critical danger. Cold sweat poured down his face, which had turned deathly pale, and his lips were already tinged with the blue hue of impending mortality. He was a retired high school history teacher, a warm and ordinary patriarch who had been counting down the days until he could hold his first grandchild. But now, instead of the future he had so longed for, he stood at the frigid threshold of death.

Dr. Park immediately ordered a chest CT scan. Every second was a desperate struggle between life and death. The moment thousands of cross-sectional images were transmitted to the server, the hospital’s cutting-edge AI diagnostic system erupted with a sharp warning, filling the screen.

[CLINICAL AI ALERT: Real-time Diagnostic Result]

·         Diagnosis: Massive Pulmonary Embolism

·         Probability Analysis: 97.8%

·         Recommendation: Immediate Anticoagulation

The conclusion drawn by the AI was overwhelming. The massive filling defect blocking the pulmonary artery on the screen was a textbook, classic representation of pulmonary embolism. Dr. Park and the medical team trusted the AI’s judgment; in the high-pressure environment of the ER, a 97.8% certainty leaves little room for doubt. Just as they were about to administer the anticoagulants, Professor Seo Yoon-ah of the Radiology Department, who had been staring intently at the monitor in the reading room, felt a sudden, intense tension.

Her eyes were catching "something" the AI could not see.

[Medical Insight: Pulmonary Embolism vs. Pulmonary Artery Sarcoma]


Professor Seo’s fingertips trembled. While the AI, backed by tens of thousands of data points, was convinced it was a "blood clot," the pulmonary artery she saw in Mr. Kim’s scans was strangely distorted, reaching beyond the vessel's boundaries. This was not a simple blockage. It was a "shadow of death," growing slowly yet massively within the pulmonary artery.

Was Mr. Kim truly suffering from a pulmonary embolism as the AI diagnosed, or was it something far more lethal, as Professor Seo’s intuition suggested—something blocking the path to his heart? At 2:17 AM, the emergency room stood at the first crossroads toward the truth.

 

Part I: The Trap of Statistics and the Intuition of Man

 

At 4:00 AM, the university hospital ER was filled with the mechanical beep-beep of monitors and cold, sterile lighting. 64-year-old Kim Jung-ho lay beneath a monitor displaying precarious numbers, clutching at the threads of life while dependent on a high-concentration oxygen mask. His lungs felt as if they were crushed under a heavy rock, unable to take in air. The medical team, relying solely on the clear-cut diagnosis of the Artificial Intelligence (AI), was busy preparing for immediate anticoagulant therapy.

Amidst this frantic activity, however, 20-year veteran radiologist Professor Seo Yoon-ah was struggling alone in the darkness of the reading room. Her eyes were locked onto the images she had reloaded dozens, perhaps hundreds, of times.

"It’s strange... it looks too perfectly like a pulmonary embolism."

Her whisper echoed into the void. If this were a simple clot, why was the diameter of the pulmonary artery so abnormally dilated? A cold chill ran down her spine. The memory of a rare cancer, "pulmonary artery sarcoma," which she had encountered in the corner of a dust-covered textbook during her green days as a resident 20 years ago, struck her mind. With a 0.001% incidence rate, it was a monster so rare that even in the medical community, it was talked about like a legend.

At the same time, the scene in the guardian’s waiting room was heartbreaking. His wife, Lee Su-jin, was sobbing while looking at a photo on her phone. In the picture, her husband, Kim Jung-ho, was smiling brightly while meticulously assembling a baby crib for their first grandchild. Faced with such a trial befalling this kind man who had lived his life upright as a history teacher, his wife’s heart was shattering. Their son, Min-su, rushed over to hold his mother’s cold, lifeless hands, but they sat there, trembling in anxiety, unaware of the true nature of the massive tragedy that had engulfed their lives.

At 7:00 AM, the thrombolysis began. Emergency measures were taken to dissolve the obstruction, but shortly after, the first words from the lead specialist froze the air in the operating room.

"Something is wrong... the clot is too hard. It’s like a tree root; it’s anchored firmly to the vessel wall and won't detach!"

The medical team was thrown into chaos. The AI system continued to churn out data, still asserting "pulmonary embolism" with an overwhelming 98.1% probability. As the entire hospital system sided with the AI’s statistics, Professor Seo Yoon-ah burst out of the reading room and shouted with resolve:

"Stop the procedure! This is not a blood clot. It’s a pulmonary artery sarcoma!"

In a moment that seemed destined for a glorious victory of data, Professor Seo was certain of one thing: what was needed in this moment was not an algorithm processing billions of data points, but the fervent intuition of a human who had spent a lifetime facing patients’ images—a profound insight capable of piercing through the very shadow of death.

[Medical Insight: The Importance of Clinical Multidisciplinary Team Care]


 

This is a web novel adapted from the blog “https://leesangbock.blogspot.com/2026/06/primary-pulmonary-artery-sarcoma-vs-pulmonary-embolism-imaging-ai.html”.

 
To be continued. "Part II: The Temperature of Solitude That Machines Could Not Read"

 https://medicalhumanstory.blogspot.com/2026/06/medical-human-story-primary-pulmonary-artery-sarcoma-ai-diagnosis_0494236203.html

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