Diffuse tumor microembolism: a rare cause of a high-probability perfusion scan.
Pulmonary tumor embolism is a rare but well-documented cause of respiratory failure in patients with cancer. This entity is probably clinically underrecognized and may represent an important cause of morbidity and mortality. A typical pattern of multiple peripheral subsegmental defects on perfusion lung scanning has been described. We present a case of a unilateral near absence of perfusion in a 53-year-old woman who on autopsy was found to have diffuse tumor microembolism. As new chemotherapeutic agents are developed for the treatment of malignancies, an early diagnosis may become more important. A high-probability perfusion scan should not dissuade the clinician from pursuing further evaluation. Cytologic findings of pulmonary venous blood may be diagnostic.
Moores
L K
LK
Department of Medicine, Walter Reed Army Medical Center, Washington, DC 20307-5001, USA.
Burrell
L M
LM
Morse
R W
RW
Belgrave
C H
CH
Balingit
A G
AG
D001943:Breast Neoplasms / Q000473:pathology*; D005260:Female; D006801:Humans; D000860:Hypoxia / Q000209:etiology; D008168:Lung / Q000000981:diagnostic imaging*; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary*; D008875:Middle Aged; D009360:Neoplastic Cells, Circulating / Q000473:pathology*; D011877:Radionuclide Imaging