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[Pathology of pulmonary embolism]
1First Department of Pathology, Nagoya University, School of Medicine.
Kokyu to Junkan. Respiration & Circulation
|June 1, 1991
Summary
Pulmonary embolism (PE) occurred in 15.4% of autopsies, with acute fatal PE causing 6.0% of deaths. This incidence, higher than previously reported in Japan, highlights the significance of PE in clinical pathology.
Area of Science:
- Pathology
- Cardiovascular Medicine
- Oncology
Background:
- Pulmonary embolism (PE) is a significant cause of morbidity and mortality.
- Autopsy studies provide crucial data on disease incidence and etiology.
- Previous data on PE incidence in Japan suggested a lower prevalence.
Observation:
- A survey of 500 autopsy records (1984-1989) at Nagoya University Hospital revealed a PE incidence of 15.4% (77 cases).
- Acute fatal PE accounted for 6.0% (30 cases) of deaths.
- Thromboembolism was the primary cause (34 cases), with venous thrombi linked to intravenous catheters in 15 cases.
Findings:
- Tumor emboli were identified in 18 cases, including sarcomas, hepatocellular carcinomas, and renal cell carcinomas.
- Fungal emboli, predominantly Aspergillus, were observed in 19 cases, particularly in immunocompromised patients (14 cases).
- The overall PE incidence in this series was comparable to rates reported in the USA and Western Europe.
Implications:
- The findings suggest a higher PE incidence in Japan than previously recognized, necessitating updated clinical awareness and diagnostic strategies.
- Understanding the diverse etiologies of PE, including thromboembolism, tumor, and fungal emboli, is critical for patient management.
- Clinicopathological analysis of specific cases, such as post-traumatic, catheter-related, tumor, fungal, amniotic fluid, and bone marrow embolism, offers valuable insights for clinical practice.