An autopsy case of a patient with systemic sclerosis who developed marked pulmonary hypertension because of pulmonary tumor thrombotic microangiopathy caused by gastric carcinoma

Yamauchi, Yusuke; Nakano, Kazuhisa; Miyagawa, Ippei; Inaba, Yuna; Nawata, Aya; Sato, Naoko; Kumei, Shinsuke; Kawanami, Toshinori; Yatera, Kazuhiro; Tanaka, Yoshiya

doi:10.1080/24725625.2019.1690767

Cited by 1 publication

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“…Gastric cancer was the most common type of cancer (11 patients, 52.4%) [ 1 ]. The pathologic features of PTTM are (1) arteriole fibroblastic intima thickening, (2) tumor embolism, and (3) thrombus formation and recommunication [ 4 ]. Tumor embolism occurs at the level of the pulmonary arterioles, followed by thrombus formation due to intimal attachment and intima damage by the tumor cells.…”

Section: Discussionmentioning

confidence: 99%

Pulmonary Tumor Thrombotic Microangiopathy Secondary to Extramammary Paget’s Disease: An Autopsy Case Report and Literature Review

et al. 2021

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Pulmonary tumor thrombotic microangiopathy is a fatal disease secondary to some malignant tumors, such as gastric cancer, esophageal cancer, and pancreatic cancer. A 61-year-old man presented to our clinic with a red plaque with erosion on his scrotum and was diagnosed with extramammary Paget’s disease. Seven years after the initial diagnosis, multiple bone metastases were discovered, and he was started on oral administration of tegafur/gimeracil/oteracil. Two years after beginning the oral drug administration, the patient complained of dyspnea. A chest CT scan showed ground-glass opacity. Pulmonary artery blood cytology revealed carcinoma cells. He was diagnosed with pulmonary tumor thrombotic microangiopathy. At 9 days after the diagnosis, he died of circulatory and respiratory failure. The autopsy revealed microscopic metastatic tumor emboli in multiple pulmonary vessels with fibrin thrombus, which confirmed the earlier cytologic diagnosis. Observations in our case were consistent with the typical pattern of this pathology in the lung with multiple metastases. Pulmonary tumor thrombotic microangiopathy with a primary disease of cutaneous malignancy is extremely rare. Here, we report a rare case of pulmonary tumor thrombotic microangiopathy secondary to extramammary Paget’s disease with a literature review.

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Section: Discussionmentioning

confidence: 99%