[An autopsy case of cor pulmonale due to a pulmonary tumor embolism as the first clinical manifestation of occult gastric cancer].
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.
Matsuda
Hiroyuki
H
Second Division, Department of Internal Medicine, Hamamatsu University, School of Medicine, Hamamatsu, Shizuoka 431-3192, Japan.
Chida
Kingo
K
Miwa
Seiiti
S
Nakano
Hideki
H
Kuwata
Hirofumi
H
Suzuki
Kenichiro
K
Yokomura
Koshi
K
Asada
Kazuhiro
K
Nakamura
Yutaro
Y
Inui
Naoki
N
Suda
Takafumi
T
Nakamura
Hirotoshi
H
Naito
Yasuhisa
Y
Sugimura
Haruhiko
H
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*