진행성 위암에서 동반된 폐동맥 종양 혈전성 미세혈관병증 1예
A Case of Pulmonary Tumor Thrombotic Microangiopathy in a Patient with Advanced Gastric Cancer
1
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Pulmonary tumor thrombotic microangiopathy (PTTM) is a rare and fatal cancer-related pulmonary complication leading to severepulmonary hypertension, right heart failure, and death. Few cases of PTTM have been diagnosed antemortem. A 62-year-oldmale showing complete remission of gastric cancer presented with exertional dyspnea. Transthoracic echocardiography showedmarked dilation of the right atrium, right ventricle, and the small left ventricle with normal left ventricular function. Right heartcatheterization also showed mild to moderate pulmonary hypertension. A chest computed tomography scan revealed no evidence ofacute pulmonary thromboembolism, but it showed consolidations with subpleural nodules in both lower lobes, and a lung perfusionscan showed multifocal, non-segmental perfusion defects. Finally, a diagnostic lung biopsy with video-assisted thoracoscopic surgerywas performed, and the pathologic findings were compatible with PTTM. Here, we report a case of gastric cancer-relatedPTTM that was diagnosed antemortem.
Abstract
Pulmonary tumor thrombotic microangiopathy (PTTM) is a rare and fatal cancer-related pulmonary complication leading to severepulmonary hypertension, right heart failure, and death. Few cases of PTTM have been diagnosed antemortem. A 62-year-oldmale showing complete remission of gastric cancer presented with exertional dyspnea. Transthoracic echocardiography showedmarked dilation of the right atrium, right ventricle, and the small left ventricle with normal left ventricular function. Right heartcatheterization also showed mild to moderate pulmonary hypertension. A chest computed tomography scan revealed no evidence ofacute pulmonary thromboembolism, but it showed consolidations with subpleural nodules in both lower lobes, and a lung perfusionscan showed multifocal, non-segmental perfusion defects. Finally, a diagnostic lung biopsy with video-assisted thoracoscopic surgerywas performed, and the pathologic findings were compatible with PTTM. Here, we report a case of gastric cancer-relatedPTTM that was diagnosed antemortem.
참고문헌 (10)
- von Herbay A, "Pulmonary tumor thrombotic microangiopathy with pulmonary hypertension", Cancer, 66, pp.587~592 (1990)
- Yoo JH, "Pulmonary tumor thrombotic microangiopathy in a patient with breast cancer", Korean J Med, 76(1), pp.S87~S92 (2009)
- Babu RV, "A 39-year-old man with epigastric pain, intermittent chest pain, and progressive dyspnea", Chest, 132, pp.2012~2015 (2007)
- Chinen K, "Pulmonary tumor thrombotic microangiopathy in patients with gastric carcinoma: an analysis of 6 autopsy cases and review of the literature", Pathol Res Pract, 206, pp.682~689 (2010)
- Yao DX, "Pulmonary tumor thrombotic microangiopathy: an often missed antemortem diagnosis", Arch Pathol Lab Med, 125, pp.304~305 (2001)
- Uruga H, "Pulmonary tumor thrombotic microangiopathy: a clinical analysis of 30 autopsy cases", Intern Med, 52, pp.1317~1323 (2013)
- Miyoshi S, "Pulmonary tumor thrombotic microangiopathy associated with lung cancer", J Cardiol Cases, 1, pp.e120~e123 (2010)
- Cicone F, "Fatal pulmonary tumour thrombotic microangiopathy: do typical FDG-PET findings exist", Nuklearmedizin, 51, pp.N6~9 (2012)
- Keenan NG, "Fatal acute pulmonary hypertension caused by pulmonary tumour thrombotic microangiopathy", Int J Cardiol, 124, pp.e11~13 (2008)
- Kitamura A, "A case of pulmonary tumor thrombotic microangiopathy diagnosed by transbronchial lung biopsy and treated with chemotherapy and long-term oxygen and anticoagulation therapies", Case Rep Pulmonol, 2013, pp.259080~ (2013)