Department of Respiratory Medicine, Japan Community Health Care Organization Kyushu Hospital, Japan.
Department of Radiology, Japan Community Health Care Organization Kyushu Hospital, Japan.
Intern Med. 2021 Sep 1;60(17):2843-2846. doi: 10.2169/internalmedicine.6553-20. Epub 2021 Mar 15.
A 70-year-old woman was hospitalized with dyspnea. A transthoracic echocardiogram indicated an elevated systolic pulmonary artery pressure, and the cytology specimens obtained using a pulmonary artery catheter confirmed adenocarcinoma metastasis. Diffusion-weighted whole-body imaging with background body signal suppression (DWIBS) detected high-signal-intensity lesions in the urinary bladder. The patient died of respiratory failure and a postmortem examination was performed. Tumor cells in the bladder were immunohistochemically positive for GATA3, indicating micropapillary urothelial carcinoma, which is a rare variant of urothelial carcinoma and considered an adenocarcinoma subtype. This case is the first autopsy case of pulmonary tumor thrombotic microangiopathy (PTTM) associated with micropapillary urothelial carcinoma of the urinary bladder.
一位 70 岁女性因呼吸困难住院。经胸超声心动图提示收缩期肺动脉压升高，肺动脉导管获取的细胞学标本证实为腺癌转移。全身弥散加权背景抑制成像（DWIBS）检测到膀胱内高信号强度病变。患者死于呼吸衰竭，并进行了尸检。膀胱中的肿瘤细胞免疫组化 GATA3 阳性，提示微乳头尿路上皮癌，这是尿路上皮癌的一种罕见变异型，被认为是腺癌亚型。本例是首例与膀胱微乳头尿路上皮癌相关的肺肿瘤血栓性微血管病（PTTM）的尸检病例。
