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[1例转移性乳腺癌合并肺肿瘤血栓性微血管病]

[A case of metastatic breast cancer complicated by pulmonary tumor thrombotic microangiopathy].

作者信息

Guo W L, Hou P, Tan W G, Lei Y X, Wu X F, Huang H Q, Hong C

机构信息

State Key Laboratory of Respiratory Diseases/National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Department of Respiratory Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510163, China.

State Key Laboratory of Respiratory Diseases/National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Department of Nuclear Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510163, China.

出版信息

Zhonghua Jie He He Hu Xi Za Zhi. 2023 Oct 12;46(10):1014-1018. doi: 10.3760/cma.j.cn112147-20230521-00253.

Abstract

Pulmonary tumor thrombotic microangiopathy is a malignancy-related complication with rapid progression and high mortality. To improve the understanding of the disease, early diagnosis and treatment are key to successful treatment. A 39-year-old patient with pulmonary hypertension transferred from another hospital was admitted to the First Affiliated Hospital of Guangzhou Medical University on September 26, 2021. The patient developed shortness of breath and progressive exacerbation over the past month. No pulmonary artery embolism was seen on computed tomography pulmonary angiography (CTPA) at the outside hospital where the breast cancer was diagnosed. Pulmonary tumor thrombotic microangiopathy was immediately considered on admission and oncological endocrine therapy was started. After treatment, the patient's dyspnoea improved, PET-CT showed significant tumor regression, and cardiac ultrasound showed a significant decrease in pulmonary artery pressure. The successful treatment experience of this case was summarized for reference.

摘要

肺肿瘤血栓性微血管病是一种与恶性肿瘤相关的并发症,进展迅速且死亡率高。为提高对该疾病的认识,早期诊断和治疗是成功治疗的关键。一名从外院转入的39岁肺动脉高压患者于2021年9月26日入住广州医科大学附属第一医院。患者在过去一个月出现气短且进行性加重。在外院诊断为乳腺癌,胸部CT血管造影(CTPA)未发现肺动脉栓塞。入院后立即考虑为肺肿瘤血栓性微血管病并开始肿瘤内分泌治疗。治疗后,患者呼吸困难改善,PET-CT显示肿瘤显著退缩,心脏超声显示肺动脉压力显著下降。总结该病例的成功治疗经验以供参考。

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