Pulmonary Tumor Thrombotic Microangiopathy Due to Gastric Cancer Diagnosed Antemortem by a Cytological Examination of Aspirated Pulmonary Artery Blood.


Journal

Internal medicine (Tokyo, Japan)
ISSN: 1349-7235
Titre abrégé: Intern Med
Pays: Japan
ID NLM: 9204241

Informations de publication

Date de publication:
15 May 2022
Historique:
pubmed: 22 10 2021
medline: 18 5 2022
entrez: 21 10 2021
Statut: ppublish

Résumé

A 66-year-old Japanese man receiving systemic chemotherapy for advanced gastric cancer presented with exertional dyspnea. D-dimer was elevated in the blood. Echocardiography revealed pulmonary hypertension, and a ventilation-perfusion scan indicated decreased perfusion in the bilateral lungs. Cardiac catheterization showed no evidence of pulmonary artery embolization and revealed cytologically confirmed adenocarcinoma. Thus, pulmonary tumor thrombotic microangiopathy (PTTM) was diagnosed. The patient died of respiratory failure on the 17th hospitalization day despite systemic chemotherapy. Retrospective serological testing revealed increased vascular endothelial growth factor in the pulmonary artery blood. This is a rare case with antemortem cytologically proven PTTM mediated by VEGF.

Identifiants

pubmed: 34670901
doi: 10.2169/internalmedicine.8313-21
pmc: PMC9177363
doi:

Substances chimiques

Vascular Endothelial Growth Factor A 0

Types de publication

Case Reports Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1491-1495

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Auteurs

Yasuhiro Mitsui (Y)

Department of Gastroenterology and Oncology, Tokushima University Hospital, Japan.

Mai Yagi (M)

Department of Gastroenterology and Oncology, Tokushima University Graduate School of Biomedical Sciences, Japan.
Department of Gastroenterology, Tokushima Prefectural Central Hospital, Japan.

Sho Muraki (S)

Department of Gastroenterology and Oncology, Tokushima University Graduate School of Biomedical Sciences, Japan.
Department of Gastroenterology, Shikoku Medical Center for Children and Adults, Japan.

Tomomi Matsuura (T)

Department of Cardiovascular Medicine, Tokushima University Hospital, Japan.

Yoshimi Bando (Y)

Division of Pathology, Tokushima University Hospital, Japan.

Shota Fujimoto (S)

Department of Gastroenterology and Oncology, Tokushima University Graduate School of Biomedical Sciences, Japan.

Shinji Kitamura (S)

Department of Gastroenterology and Oncology, Tokushima University Graduate School of Biomedical Sciences, Japan.

Koichi Okamoto (K)

Department of Gastroenterology and Oncology, Tokushima University Hospital, Japan.

Naoki Muguruma (N)

Department of Gastroenterology and Oncology, Tokushima University Graduate School of Biomedical Sciences, Japan.

Masataka Sata (M)

Department of Cardiovascular Medicine, Tokushima University Hospital, Japan.

Tetsuji Takayama (T)

Department of Gastroenterology and Oncology, Tokushima University Graduate School of Biomedical Sciences, Japan.

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Classifications MeSH