Ohguchi Hideomi, Imaeda Kenro, Hotta Asami, Kakoi Shouta, Yasuda Satoshi, Shimizu Yuki, Hayakawa Akiko, Mishina Haruka, Hasegawa Chie, Ito Shunsuke, Ogawa Kento, Yagi Takashi, Koyama Hiroyuki, Tanaka Tomohiro, Kato Hiroyuki, Takahashi Satoru, Joh Takashi
Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Japan.
Department of Experimental Pathology and Tumor Biology, Nagoya City University Graduate School of Medical Sciences, Japan.
Intern Med. 2018 Sep 1;57(17):2533-2539. doi: 10.2169/internalmedicine.0204-17. Epub 2018 Mar 30.
We herein describe a case of pulmonary tumor thrombotic microangiopathy (PTTM) with rapidly progressing colon cancer. A 61-year-old man who had been receiving treatment for type 2 diabetes mellitus for 3 years was hospitalized due to critical hypoxemia. Computed tomography, which had not shown any abnormalities 3 months previously, revealed a tumor in the ascending colon, multiple nodules in the liver, and the absence of any lung abnormalities. On day 3 of hospitalization, a sudden onset of severe dyspnea and tachycardia occurred, followed by death. Autopsy revealed microscopic metastatic tumor emboli in multiple pulmonary vessels with fibrin thrombus and intimal proliferation, which led to a diagnosis of PTTM.
我们在此描述一例伴有快速进展性结肠癌的肺肿瘤血栓性微血管病（PTTM）。一名61岁男性，患2型糖尿病已接受治疗3年，因严重低氧血症住院。3个月前计算机断层扫描未显示任何异常，此次检查发现升结肠有肿瘤、肝脏有多个结节，肺部无异常。住院第3天，患者突然出现严重呼吸困难和心动过速，随后死亡。尸检显示多个肺血管内有微小转移性肿瘤栓子，伴有纤维蛋白血栓和内膜增生，据此诊断为PTTM。
