Subacute cor pulmonale due to tumor embolization to the lungs

Six patients with subacute cor pulmonale due to tumor embolization to the lungs were reported from China. Five of the 6 patients suffered from progressive unrelenting dyspnea; 4 had completely normal cardiopulmonary findings on physical examination. Four of the 5 patients who had chest roentgenograms showed diffuse bilateral mottling of the lungs with no evidence of cardiomegaly. At autopsy right ventricular hypertrophy was present in all. The pathologic findings in the lungs consisted of multiple microscopic tumor emboli distributed diffusely in the pulmonary arterioles and/or perivascular lymphatics; the lumen of these vessels was obliterated with or without hyperplastic endarteritis. Although the outcome of this not uncommon clinicopathologic entity is generally fatal, early diagnosis followed by prompt effective therapy for the underlying primary neoplasm has been reported to prolong survival.