Higashi Akifumi, Dohi Yoshihiro, Uraoka Naohiro, Sentani Kazuhiro, Uga Sayuri, Kinoshita Hiroki, Sada Yoshiharu, Kitagawa Toshiro, Hidaka Takayuki, Kurisu Satoshi, Yamamoto Hideya, Yasui Wataru, Kihara Yasuki
Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences, Japan.
Intern Med. 2015;54(22):2877-80. doi: 10.2169/internalmedicine.54.4749. Epub 2015 Nov 15.
Pulmonary tumor thrombotic microangiopathy (PTTM) is a rare and fatal cancer-related complication. We herein present a case of PTTM that diagnosed antemortem by lung scintigraphy and pulmonary microvascular cytology. The patient was treated with steroid pulse therapy. Although her symptoms temporarily improved, she died of respiratory failure. An autopsy showed PTTM, and an immunohistochemical analysis revealed the expression of osteopontin and CD44 in macrophages that had migrated into the PTTM lesions. These findings suggest that inflammation associated with the interaction between osteopontin and CD44 may play an important role in PTTM.
肺肿瘤血栓性微血管病（PTTM）是一种罕见且致命的癌症相关并发症。我们在此报告一例通过肺闪烁显像和肺微血管细胞学进行生前诊断的PTTM病例。该患者接受了类固醇脉冲疗法。尽管她的症状暂时有所改善，但最终死于呼吸衰竭。尸检显示为PTTM，免疫组织化学分析显示迁移到PTTM病变中的巨噬细胞中骨桥蛋白和CD44表达。这些发现表明，骨桥蛋白和CD44相互作用相关的炎症可能在PTTM中起重要作用。
