A Long-term Survival Case of Pulmonary Tumor Thrombotic Microangiopathy due to Gastric Cancer Confirmed by the Early Diagnosis based on a Transbronchial Lung Biopsy

Intern Med. 2020;59(13):1621-1627. doi: 10.2169/internalmedicine.3630-19. Epub 2020 Jul 1.

Abstract

Pulmonary tumor thrombotic microangiopathy (PTTM) is an acute, progressive, and fatal disease. PTTM manifests as subacute respiratory failure with pulmonary hypertension, progressive right-sided heart failure, and sudden death. An antemortem diagnosis of PTTM is very difficult to obtain, and many patients die within several weeks. We herein report a case of PTTM diagnosed based on a transbronchial lung biopsy. In this case, we finally diagnosed PTTM due to gastric cancer because of its histological identity. The patient was administered chemotherapy, including angiogenesis inhibitors, against gastric cancer at an early age and survived for a long time.

Keywords: angiogenesis inhibitor; gastric cancer; pulmonary tumor thrombotic microangiopathy; transbronchial lung biopsy.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adenocarcinoma / complications*
  • Adenocarcinoma / pathology
  • Adult
  • Aged
  • Aged, 80 and over
  • Angiogenesis Inhibitors / therapeutic use
  • Biopsy
  • Disease Progression
  • Fatal Outcome
  • Humans
  • Hypertension, Pulmonary / drug therapy
  • Hypertension, Pulmonary / etiology
  • Lung / diagnostic imaging
  • Lung / pathology*
  • Lung Neoplasms / complications*
  • Lung Neoplasms / pathology
  • Male
  • Middle Aged
  • Radiography, Thoracic
  • Stomach Neoplasms / complications*
  • Thrombotic Microangiopathies / diagnosis
  • Thrombotic Microangiopathies / etiology*
  • Tomography, X-Ray Computed

Substances

  • Angiogenesis Inhibitors