An autopsy case of pulmonary tumor thrombotic microangiopathy that occurred during chemotherapy for gastric cancer
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- HIGASHI Keinosuke
- Department of Gastroenterology, Ishikawa Prefectural Central Hospital
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- TSUJI Shigetsugu
- Department of Gastroenterology, Ishikawa Prefectural Central Hospital
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- TSUJI Kunihiro
- Department of Gastroenterology, Ishikawa Prefectural Central Hospital
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- YOSHIDA Naohiro
- Department of Gastroenterology, Ishikawa Prefectural Central Hospital
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- TOMINAGA Kei
- Department of Gastroenterology, Ishikawa Prefectural Central Hospital
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- TAKEMURA Kenichi
- Department of Gastroenterology, Ishikawa Prefectural Central Hospital
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- YAMADA Shinya
- Department of Gastroenterology, Ishikawa Prefectural Central Hospital
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- INAKI Noriyuki
- Department of Gastroenterological Surgery, Ishikawa Prefectural Central Hospital
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- KURUMAYA Hiroshi
- Department of Diagnostic Pathology, Ishikawa Prefectural Central Hospital
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- DOYAMA Hisashi
- Department of Gastroenterology, Ishikawa Prefectural Central Hospital
Bibliographic Information
- Other Title
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- 胃癌の化学療法中に生じたpulmonary tumor thrombotic microangiopathy（PTTM）の1剖検例
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Abstract
A man in 60s underwent total gastrectomy for advanced gastric cancer with para-aortic lymph node metastases. Although postoperative chemotherapy decreased the metastases, he was subsequently admitted with progressive respiratory distress. Pulmonary hypertension and right-sided heart failure developed, and he died of sudden cardiopulmonary arrest 30 hours after admission. Autopsy revealed widespread tumor embolism, fibrocellular intimal proliferation, and thrombus formation in the small arteries, consistent with a diagnosis of pulmonary tumor thrombotic microangiopathy (PTTM) associated with gastric cancer. Although PTTM a rare clinicopathological entity that causes severe pulmonary hypertension, it should be considered as a differential diagnosis for acute dyspnea or pulmonary hypertension in patients with carcinoma, regardless of clinical improvement.
Journal
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- Nippon Shokakibyo Gakkai Zasshi
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Nippon Shokakibyo Gakkai Zasshi 111 (7), 1399-1407, 2014
The Japanese Society of Gastroenterology