Pulmonary tumour microembolism clinically mimicking alveolitis.
A 56 year old man with previously unsuspected recurrence of squamous cell carcinoma of the oesophagus presented with dyspnoea. Bronchoscopy and computed tomography suggested bronchopneumonic changes with an infectious cause. He suffered a rapidly deteriorating course and died despite active treatment, including antibiotics and mechanical ventilation. Necropsy revealed a florid pulmonary tumour microembolism mimicking alveolitis. No bronchopneumonia was seen. The emboli arose from loosely attached tumour vegetations in the tricuspid valve. In a patient with known malignancy, tumour microembolism should be considered as an uncommon cause of rapid respiratory failure, refractory to antibiotic treatment.
Lo
A W I
AW
Department of Anatomical and Cellular Pathology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, NT, Hong Kong SAR, China.
Tse
G M K
GM
Chu
W C W
WC
Chan
A B W
AB
D002294:Carcinoma, Squamous Cell / Q000150:complications; D003937:Diagnosis, Differential; D004938:Esophageal Neoplasms / Q000150:complications; D017809:Fatal Outcome; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000556:secondary*; D008297:Male; D008875:Middle Aged; D009360:Neoplastic Cells, Circulating / Q000473:pathology*; D011014:Pneumonia / Q000175:diagnosis*; D011650:Pulmonary Alveoli; D011655:Pulmonary Embolism / Q000175:diagnosis* / Q000209:etiology