Occult gastric cancer presenting as cor pulmonale resulting from tumor cell microembolism.
Cor pulmonale resulting from tumor emboli is a rare presentation of gastric cancer, and only six similar cases have been reported in the English literature. We report the case of a 37-yr-old woman presenting with dyspnea who died of cor pulmonale. Autopsy revealed signet cell carcinoma of te stomach with intra-abdominal metastasis and right ventricular hypertrophy. There were no macroscopic pulmonary emboli or parenchymal lesions, but more than 60% of the small pulmonary arteries and arterioles were occluded. In most vessels, fibrocellular intimal proliferation was the major finding with only a few entrapped tumor cells.
Cheung
T C
TC
Department of Medicine, Ruttonjee Hospital, Hong Kong.
Ng
F H
FH
Chow
K C
KC
Maw
C K
CK
Ng
W F
WF
D000008:Abdominal Neoplasms / Q000556:secondary; D000328:Adult; D001158:Arteries / Q000473:pathology; D001160:Arterioles / Q000473:pathology; D018279:Carcinoma, Signet Ring Cell / Q000175:diagnosis / Q000556:secondary*; D003937:Diagnosis, Differential; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D008168:Lung / Q000098:blood supply; D008175:Lung Neoplasms / Q000175:diagnosis / Q000556:secondary*; D009382:Neoplasms, Unknown Primary / Q000175:diagnosis*; D009360:Neoplastic Cells, Circulating / Q000473:pathology*; D011660:Pulmonary Heart Disease / Q000175:diagnosis*; D013274:Stomach Neoplasms / Q000175:diagnosis*