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Subacute cor pulmonale due to tumor embolism
Hiroyuki Nakamura1, Hideki Adachi, Akihiko Sudoh
1Fifth Department of Internal Medicine, Tokyo Medical University, 3-20-1 Chuo Amicho, Inashiki-gun, Ibaraki 300-0395.
Internal Medicine (Tokyo, Japan)
|June 23, 2004
Summary
Subacute cor pulmonale can result from tumor emboli in the lungs. This case highlights pulmonary tumor embolism as a crucial diagnosis for pulmonary hypertension, especially in cancer survivors.
Area of Science:
- Oncology
- Pulmonary Medicine
- Pathology
Background:
- Subacute cor pulmonale is a severe condition characterized by pulmonary hypertension.
- Tumor embolism in the lungs can lead to significant cardiopulmonary compromise.
Observation:
- A 64-year-old female presented with progressive cough and dyspnea, rapidly developing severe pulmonary hypertension.
- Initial diagnostic imaging, including chest CT and lung perfusion scintigraphy, yielded no conclusive findings.
- Autopsy revealed widespread intravascular tumor emboli occluding pulmonary arteries, arterioles, and lymphatic vessels.
Findings:
- The tumor emboli were identified as metastases from a previously resected breast carcinoma.
- Diffuse intravascular tumor embolism was the cause of the patient's fatal pulmonary hypertension.
Implications:
- Pulmonary tumor embolism should be considered in the differential diagnosis of primary pulmonary hypertension.
- A history of cancer, particularly breast carcinoma, increases suspicion for pulmonary tumor embolism in patients with unexplained pulmonary hypertension.