Insights on pulmonary tumor thrombotic microangiopathy: a seven‐patient case series
Autor: | Nader Kamangar, Alexander Zider, William D. Wallace, Robert D. Suh, Rajan Saggar, Jamie Betancourt, Rohit Godbole |
---|---|
Rok vydání: | 2017 |
Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty Thrombotic microangiopathy Case Reports Cardiorespiratory Medicine and Haematology Cardiovascular Malignancy Metastatic carcinoma 03 medical and health sciences Rare Diseases 0302 clinical medicine pulmonary arterial hypertension medicine.artery pulmonary pathology medicine Pulmonary pathology Lung Cancer business.industry Hematology medicine.disease Pulmonary hypertension Heart Disease 030228 respiratory system 030220 oncology & carcinogenesis Heart failure Pulmonary artery Radiology chest imaging Transthoracic echocardiogram business |
Zdroj: | Pulmonary Circulation Pulmonary circulation, vol 7, iss 4 Godbole, R; Saggar, R; Zider, A; Betancourt, J; Wallace, WD; Suh, RD; et al.(2017). Insights on pulmonary tumor thrombotic microangiopathy: a seven-patient case series. PULMONARY CIRCULATION, 7(4), 813-820. doi: 10.1177/2045893217728072. UCLA: Retrieved from: http://www.escholarship.org/uc/item/6v5620sp |
ISSN: | 2045-8940 |
Popis: | Pulmonary tumor thrombotic microangiopathy (PTTM) is a disease process wherein tumor cells are thought to embolize to the pulmonary circulation causing pulmonary hypertension (PH) and death from right heart failure. Presented herein are clinical, laboratory, radiographic, and histologic features across seven cases of PTTM. Highlighted in this publication are also involvement of pulmonary venules and clinical features distinguishing PTTM from clinical mimics. We conducted a retrospective chart review of seven cases of PTTM from hospitals in the greater Los Angeles metropolitan area. Patients in this series exhibited: symptoms of cough and progressive dyspnea; PH and/or heart failure on physical exam; laboratory abnormalities of anemia, thrombocytopenia, elevated LDH, and elevated D-dimer; chest computed tomography (CT) showing diffuse septal thickening, mediastinal and hilar lymphadenopathy and nodules; elevated pulmonary artery pressures on transthoracic echocardiogram and/or right heart catheterization; and presence of malignancy. Tumor emboli and fibrocellular intimal proliferation were seen in pulmonary arterioles, while two patients had pulmonary venopathy. PTTM is a devastating disease occurring in patients with metastatic carcinoma. An early diagnosis is challenging. Understanding the clinical presentation of PTTM and distinguishing PTTM from clinical mimics may help achieve an early diagnosis and allow time for initiation of treatment. |
Databáze: | OpenAIRE |
Externí odkaz: |