University of Nebraska Medical Center, Omaha, USA.
University College of Medical Sciences, Delhi, India.
J Investig Med High Impact Case Rep. 2022 Jan-Dec;10:23247096221086453. doi: 10.1177/23247096221086453.
Pulmonary tumor embolism (PTE) and pulmonary tumor thrombotic microangiopathy (PTTM) are rare etiologies for rapidly progressive dyspnea in the setting of undiagnosed metastatic cancer. They occur most frequently in association with adenocarcinomas, with PTE being most frequently associated with hepatocellular carcinoma and PTTM being most commonly reported with gastric adenocarcinoma. Pulmonary tumor embolism and PTTM appear to be a disease spectrum where PTTM represents an advanced form of PTE. Pulmonary tumor embolism and PTTM are mostly identified postmortem during autopsy as the antemortem diagnosis remains a clinical challenge due to the rapidly progressive nature of these rare diseases. We report 2 cases of rapidly progressive respiratory failure leading to death, due to tumoral pulmonary hypertension resulting from PTE and PTTM, diagnosed postmortem. Both of the patients were middle-aged females, nonsmokers, and had a gastrointestinal source of their primary malignancy.
肺肿瘤栓塞（PTE）和肺肿瘤血栓性微血管病（PTTM）是未确诊转移性癌症患者出现快速进展性呼吸困难的罕见病因。它们最常与腺癌相关，PTE 最常与肝细胞癌相关，PTTM 最常与胃腺癌相关。PTE 和 PTTM 似乎是一种疾病谱，其中 PTTM 代表 PTE 的一种晚期形式。PTE 和 PTTM 主要在尸检时通过死后发现，因为由于这些罕见疾病的快速进展性质，其生前诊断仍然是一个临床挑战。我们报告了 2 例因 PTE 和 PTTM 导致的肿瘤性肺动脉高压引起的快速进展性呼吸衰竭导致死亡的病例，这些病例均在死后诊断。这两名患者均为中年女性，不吸烟，且其原发性恶性肿瘤来源于胃肠道。
