title: [An autopsy case of cor pulmonale due to a pulmonary tumor embolism as the first clinical manifestation of occult gastric cancer].
abstract: A 47-year-old man was admitted to our hospital because of progressive dyspnea and cough. Physical examination and chest radiographs showed the signs of cor pulmonale. A lung scan using perfused radionuclide revealed multiple peripheral perfusion defects and catheterization of the right heart showed severe pulmonary hypertension. A diagnosis of severe pulmonary embolism was made. Despite intensive care with anti-coagulation therapy, the patient died on the third-hospital day. Autopsy disclosed gastric cancer in the pylorus with metastases to the regional lymph nodes. There were no macroscopic pulmonary artery emboli or parenchymal lesions, but more than 60% of the small arteries and arterioles were occluded by casts of tumor cells. Cor pulmonale due to a pulmonary tumor embolism is a rare complication of cancer. This case is particularly unusual because the embolus-caused cor pulmonale was the initial manifestation of clinically occult, but pathologically advanced, gastric cancer.
authors.affiliation: Second Division, Department of Internal Medicine, Hamamatsu University, School of Medicine, Hamamatsu, Shizuoka 431-3192, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Matsuda
authors.forename: Kingo
authors.initials: K
authors.lastname: Chida
authors.forename: Seiiti
authors.initials: S
authors.lastname: Miwa
authors.forename: Hideki
authors.initials: H
authors.lastname: Nakano
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Kuwata
authors.forename: Kenichiro
authors.initials: K
authors.lastname: Suzuki
authors.forename: Koshi
authors.initials: K
authors.lastname: Yokomura
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Asada
authors.forename: Yutaro
authors.initials: Y
authors.lastname: Nakamura
authors.forename: Naoki
authors.initials: N
authors.lastname: Inui
authors.forename: Takafumi
authors.initials: T
authors.lastname: Suda
authors.forename: Hirotoshi
authors.initials: H
authors.lastname: Nakamura
authors.forename: Yasuhisa
authors.initials: Y
authors.lastname: Naito
authors.forename: Haruhiko
authors.initials: H
authors.lastname: Sugimura
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology*; D006801:Humans; D008175:Lung Neoplasms / Q000150:complications / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009360:Neoplastic Cells, Circulating / Q000473:pathology*; D011660:Pulmonary Heart Disease / Q000209:etiology*; D013274:Stomach Neoplasms / Q000473:pathology*