Yoshii Yutaka, Kawabata Yoshinori, Takayanagi Noboru, Araya Jun, Kuwano Kazuyoshi, Sugita Yutaka
Department of Respiratory Medicine, Saitama Cardiovascular and Respiratory Center; Division of Respiratory Diseases, Department of Internal Medicine, Jikei University School of Medicine, Japan.
Intern Med. 2015;54(8):955-60. doi: 10.2169/internalmedicine.54.3476. Epub 2015 Apr 15.
A 76-year-old man complaining of exertional dyspnea was admitted to our hospital. Chest computed tomography revealed bilateral diffuse ground-glass opacities and small nodules. A transbronchial lung biopsy revealed tumor cell emboli in the pulmonary arteries. The patient was diagnosed with gastric adenocarcinoma using an endoscopic stomach biopsy; however, the interstitial opacities progressively worsened and he died of acute respiratory failure. An autopsy revealed extensive pulmonary tumor embolisms (PTE) with associated ischemic damages, e.g., infarctions, alveolar wall thickening with cuboidal metaplasia, hemorrhage, and diffuse alveolar damage. The ground-glass opacities in the chest computed tomography findings appear to correlate with the pathological ischemic changes associated with PTE.
一名76岁男性因劳力性呼吸困难入院。胸部计算机断层扫描显示双侧弥漫性磨玻璃影和小结节。经支气管肺活检显示肺动脉内有肿瘤细胞栓子。通过内镜胃活检诊断为胃腺癌；然而，间质性阴影逐渐加重，患者死于急性呼吸衰竭。尸检显示广泛的肺肿瘤栓塞（PTE）伴有相关的缺血性损害，如梗死、肺泡壁增厚伴立方上皮化生、出血和弥漫性肺泡损伤。胸部计算机断层扫描结果中的磨玻璃影似乎与PTE相关的病理缺血性改变有关。
