A Case of Pulmonary Tumor Thrombotic Microangiopathy in a Patient with Advanced Gastric Cancer.
10.3904/kjm.2014.87.5.593
- Author:
Ji Eun JUN
1
;
Jung Hoon KIM
;
Duck Hyun RYU
;
Ji Eun LEE
;
Ho Jung JEONG
;
Jeong Hoon YANG
Author Information
1. Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. jhysmc@gmail.com
- Publication Type:Case Report
- Keywords:
Pulmonary tumor thrombotic microangiopathy;
Pulmonary hypertension;
Gastric cancer
- MeSH:
Biopsy;
Cardiac Catheterization;
Cardiac Catheters;
Dyspnea;
Echocardiography;
Heart Atria;
Heart Failure;
Heart Ventricles;
Humans;
Hypertension, Pulmonary;
Lung;
Male;
Middle Aged;
Perfusion;
Pulmonary Embolism;
Stomach Neoplasms*;
Thoracic Surgery, Video-Assisted;
Thorax;
Thrombotic Microangiopathies*;
Ventricular Function, Left
- From:Korean Journal of Medicine
2014;87(5):593-597
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Pulmonary tumor thrombotic microangiopathy (PTTM) is a rare and fatal cancer-related pulmonary complication leading to severe pulmonary hypertension, right heart failure, and death. Few cases of PTTM have been diagnosed antemortem. A 62-year-old male showing complete remission of gastric cancer presented with exertional dyspnea. Transthoracic echocardiography showed marked dilation of the right atrium, right ventricle, and the small left ventricle with normal left ventricular function. Right heart catheterization also showed mild to moderate pulmonary hypertension. A chest computed tomography scan revealed no evidence of acute pulmonary thromboembolism, but it showed consolidations with subpleural nodules in both lower lobes, and a lung perfusion scan showed multifocal, non-segmental perfusion defects. Finally, a diagnostic lung biopsy with video-assisted thoracoscopic surgery was performed, and the pathologic findings were compatible with PTTM. Here, we report a case of gastric cancer-related PTTM that was diagnosed antemortem.
