Pulmonary tumor thrombotic microangiopathy resulting from metastatic signet ring cell carcinoma of the stomach

Sakashita, Naomi; Yokose, Chiharu; Fujii, Kenichi; Matsumoto, Mitsuhiro; Ohnishi, Koji; Takeya, Motohiro

doi:10.1111/j.1440-1827.2007.02111.x

Cited by 45 publications

(32 citation statements)

References 17 publications

(22 reference statements)

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“…It was first reported by von Herbay and his colleagues as a diffuse myofibroblast proliferation of small pulmonary arteries that cause severe pulmonary hypertension, leading cardiopulmonary failure and sudden death [2][3][4][5][6]. From the clinical point of view PTTM manifests with signs and symptoms of pulmonary hypertension which indicate progressive dyspnea, cough and hypoxia, as our patient presented.…”

Section: Discussionmentioning

confidence: 89%

Pulmonary Tumor Thrombotic Microangiopathy by Lung Adenocarcinoma

Furuno¹,

Tanaka

Ueno³

et al. 2013

JCR

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Abstract:Pulmonary tumor thrombotic microangiopathy, which was established as a disease entity by von Herbay et al, is an uncommon cancer-related complication. The most common disease associated with pulmonary tumor thrombotic microangiopathy is poorly differentiated adenocarcinoma of the stomach, and cancers other than gastric cancers are very rare. We present a case of pulmonary tumor thrombotic microangiopathy caused by lung adenocarcinoma which was found in a 61-year-old Japanese woman. She was taken suffering from general fatigue without any history of cancers. Two-days after admission she suddenly complained of dyspnea and succumbed to pulmonary hypertension. Postmortem autopsy revealed that lung adenocarcinoma with multiple liver metastasis and intimal proliferation of pulmonary small arteries with or without tumor emboli, which were characteristics of pulmonary tumor thrombotic microangiopathy.

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Section: Discussionmentioning

confidence: 89%

Pulmonary Tumor Thrombotic Microangiopathy by Lung Adenocarcinoma

Furuno¹,

Tanaka

Ueno³

et al. 2013

JCR

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“…Studies have suggested that certain molecules produced by tumor cells are involved in the onset and/or development of PTTM (2,3). One candidate is VEGF, a glycoprotein involved in the proliferation of endothelial cells and tumor angiogenesis.…”

Section: Discussionmentioning

confidence: 99%

“…One candidate is VEGF, a glycoprotein involved in the proliferation of endothelial cells and tumor angiogenesis. VEGF expression in tumor cells in cases of PTTM caused by gastric cancer have been reported (2,3), and one case of PTTM caused by lung adenocarcinoma expressing VEGF has also been documented (4).…”

Section: Discussionmentioning

confidence: 99%

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Pulmonary tumor thrombotic microangiopathy caused by lung adenocarcinoma: Case report with review of the literature

et al. 2011

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Abstract. Pulmonary tumor thrombotic microangiopathy (PTTM) is an uncommon cancer-related complication characterized by intimal proliferation in pulmonary small arteries and arterioles with or without tumor emboli. In the majority of cases, the causative lesion is gastric poorly differentiated adenocarcinoma. In the present study, an autopsy case of PTTM caused by lung adenocarcinoma is reported and the pathogenesis of this complication is discussed. Multiple nodular lesions in the bilateral lungs were found in a 62-yearold Japanese man. Transbronchial biopsy revealed non-small cell carcinoma. Chemotherapy was performed; however, the patient succumbed to sudden dyspnea. Autopsy revealed poorly differentiated adenocarcinoma with multiple intrapulmonary metastases and intimal proliferation of pulmonary small arteries and arterioles with or without tumor emboli, which were characteristic of PTTM. Tumor cells were immunohistochemically positive for vascular endothelial growth factor (VEGF) and osteopontin (OPN), which are endothelial proliferative factors. This case indicates the possible involvement of VEGF and OPN in the pathogenesis of PTTM caused by lung adenocarcinoma.

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“…Pulmonary thrombotic microangiopathy is uncommon, reported in only 3% to 26% of autopsied patients with solid tumors (19)(20)(21)(22), and is usually only diagnosed postmortem (23). In this condition, embolic tumor cells obstruct pulmonary vessels, activate the coagulation cascade (24), and produce infl ammatory mediators promoting thrombosis and intimal proliferation (23).…”

Section: Baylor University Medical Center Proceedingsmentioning

confidence: 99%

Malignant Rhabdoid Tumor of the Kidney Arising in an Adult Patient

Podduturi¹,

Campa-Thompson²,

Zhou³

et al. 2014

Baylor University Medical Center Proceedings

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Malignant rhabdoid tumors (MRT) of the kidney are rare in children and even less common in adults, with only six previously reported adult cases. We present the case of a 60-year-old man with an MRT arising in the left kidney with extensive pulmonary micrometastases and thromboembolism resulting in thrombotic pulmonary microangiopathy (pulmonary tumor embolism syndrome). MRT is an extremely aggressive neoplasm with a short survival time.M alignant rhabdoid tumor (MRT) of the kidney is a highly aggressive, extremely rare neoplasm that is usually seen in children. Th e term rhabdoid is used because the tumor cells resemble rhabdomyoblasts but lack myogenic markers, and pathologic diagnosis requires familiarity with these microscopic features plus awareness that adult onset is possible. We describe clinical and necropsy fi ndings in an adult with primary renal MRT. CLINICAL HISTORYA 60-year-old white man with known hypothyroidism, hypertension, and chronic obstructive pulmonary disease had progressive fatigue and abdominal distension for 6 months and worsening dyspnea for 2 weeks. Imaging showed bilateral pulmonary infi ltrates consistent with pneumonia, and he was treated at home with antibiotics and prednisone. Th ree days later, he presented to an outside emergency department with gross hematuria, left calf pain, hemoptysis, painful testicular swelling, and nontraumatic ecchymoses. He was then transferred to Baylor University Medical Center at Dallas and admitted to the intensive care unit. Examination disclosed bilateral lower-extremity edema and ecchymosis over the left calf and ankle. His body mass index was 30.4 kg/m 2 , blood pressure, 170/90 mm Hg; heart rate, 96 beats/minute; respiratory rate, 18 breaths/minute; white blood cell count, 31.9 k/μL; hemoglobin, 9.3 g/dL; hematocrit, 25.9%; platelets, 81 k/μL; prothrombin time, 18.0 seconds (reference range 9.0-12.0 seconds); blood urea nitrogen, 46.0 mg/dL; creatinine, 1.6 mg/dL; and arterial blood gas pH, 7.38. He was given heparin and multiple units of red blood cells and cryoprecipitate. Chest radiograph showed bilateral basilar and right upper lobe infi ltrates. Computed tomography showed a thrombus within the left renal vein that extended into the inferior vena cava and a mass in the mid to lower pole of the left kidney (Figure 1).Over the next few days, the patient's oxygen requirements increased, his abdomen became more distended, and his urine output decreased. A left radical nephrectomy and retroperitoneal lymph node dissection was performed. At surgery, there was no residual thrombus in the left main renal vein. Postoperatively,

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Pulmonary tumor thrombotic microangiopathy resulting from metastatic signet ring cell carcinoma of the stomach

Cited by 45 publications

References 17 publications

Pulmonary Tumor Thrombotic Microangiopathy by Lung Adenocarcinoma

Pulmonary Tumor Thrombotic Microangiopathy by Lung Adenocarcinoma

Pulmonary tumor thrombotic microangiopathy caused by lung adenocarcinoma: Case report with review of the literature

Malignant Rhabdoid Tumor of the Kidney Arising in an Adult Patient

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