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Korean J Med > Volume 87(5); 2014 > Article
The Korean Journal of Medicine 2014;87(5): 593-597.
진행성 위암에서 동반된 폐동맥 종양 혈전성 미세혈관병증 1예
전지은, 김정훈, 유덕현, 이지은, 정호중, 양정훈
성균관대학교 의과대학 내과학교실
A Case of Pulmonary Tumor Thrombotic Microangiopathy in a Patient with Advanced Gastric Cancer
Ji Eun Jun, Jung Hoon Kim, Duck Hyun Ryu, Ji Eun Lee, Ho Jung Jeong, Jeong Hoon Yang
Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
Corresponding Author: Jeong Hoon Yang ,Tel: +82-2-3410-3419, Fax: +82-2-3410-3849, Email: jhysmc@gmail.com
Received: October 13, 2013;   Revised: January 28, 2014;   Accepted: January 31, 2014.
This is an Open Access article distributed under the terms of the Creative Commons Attribution NonCommercial License (http://creativecommons.org/licenses/bync/3.0/) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
ABSTRACT
Pulmonary tumor thrombotic microangiopathy (PTTM) is a rare and fatal cancer-related pulmonary complication leading to severe pulmonary hypertension, right heart failure, and death. Few cases of PTTM have been diagnosed antemortem. A 62-year-old male showing complete remission of gastric cancer presented with exertional dyspnea. Transthoracic echocardiography showed marked dilation of the right atrium, right ventricle, and the small left ventricle with normal left ventricular function. Right heart catheterization also showed mild to moderate pulmonary hypertension. A chest computed tomography scan revealed no evidence of acute pulmonary thromboembolism, but it showed consolidations with subpleural nodules in both lower lobes, and a lung perfusion scan showed multifocal, non-segmental perfusion defects. Finally, a diagnostic lung biopsy with video-assisted thoracoscopic surgery was performed, and the pathologic findings were compatible with PTTM. Here, we report a case of gastric cancer-related PTTM that was diagnosed antemortem.
Keywords: Pulmonary tumor thrombotic microangiopathy; Pulmonary hypertension; Gastric cancer
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