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- Kyoko Unno, Hayato Ohtani, Atsushi Sakamoto, Hirotake Murakami, Haruna Yagi, Hiroaki Ito, Satoshi Baba, Toshihide Iwashita, Isao Kosugi, and Yuichiro Maekawa.
- Division of Cardiology, Internal Medicine III, Hamamatsu University School of Medicine, Japan.
- Intern. Med. 2023 Dec 15; 62 (24): 364936553649-3655.
AbstractA 48-year-old woman with advanced ovarian cancer was diagnosed with pulmonary tumor thrombotic microangiopathy (PTTM) by antemortem pulmonary wedge aspiration cytopathology. Despite the initiation of anti-cancer treatment, she unfortunately died due to progressive respiratory failure. Histopathology of the autopsied lung revealed multiple tumor embolization with fibrin-rich clot and fibro-cellular intimal proliferation at the pulmonary arteriole. The embolized tumor showed strong immune-positivity for pro-thrombotic and fibrotic factors (tissue factor and vascular endothelial growth factor), suggesting the underlying mechanisms of PTTM development. This case suggests that a quick antemortem diagnosis and the early induction of specific treatments might ensure a better prognosis of PTTM.
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