Nara M, Sasaki T, Shimura S, Yamamoto M, Oshiro T, Kaiwa Y, Kurokawa Y, Tezuka F, Shirato K
Department of Internal Medicine and Surgery, School of Medicine, Tohoku University, Sendai.
Intern Med. 1996 Aug;35(8):653-6. doi: 10.2169/internalmedicine.35.653.
A case of diffuse alveolar hemorrhage due to lung metastasis of ovarian angiosarcoma is described. A 33-year-old woman developed persistent cough and recurrent hemoptyses with resultant anemia. Chest radiograph and computerized tomography (CT) showed diffuse and patchy shadows in both lungs with nodules in the central area of the shadows. In spite of intensive care and administration of large amounts of glucocorticoids, she died of respiratory failure 5 months after the onset of her symptoms. Histological examination by both thoracoscopic biopsy and autopsy revealed diffuse tumor emboli of disseminated angiosarcoma which originated from the right ovary and diffuse alveolar hemorrhage which appeared to be caused by the tumor emboli with resultant invasion and destruction to vascular walls. This is the first description of diffuse alveolar hemorrhage probably caused by tumor emboli of metastatic angiosarcoma.
本文报道了一例因卵巢血管肉瘤肺转移导致弥漫性肺泡出血的病例。一名33岁女性出现持续咳嗽和反复咯血，并由此导致贫血。胸部X线片和计算机断层扫描（CT）显示双肺弥漫性斑片状阴影，阴影中心区域有结节。尽管进行了重症监护并给予大量糖皮质激素治疗，但她在症状出现5个月后死于呼吸衰竭。经胸腔镜活检和尸检进行的组织学检查显示，弥漫性血管肉瘤的肿瘤栓子起源于右卵巢，且存在弥漫性肺泡出血，这似乎是由肿瘤栓子导致血管壁侵袭和破坏所致。这是首次对转移性血管肉瘤的肿瘤栓子可能引起的弥漫性肺泡出血进行描述。
