title: [Tumor microembolism presenting as characteristic patterns of pulmonary perfusion on lung scanning: a case report].
abstract: A 55-year-old man presented with tumor microembolism manifesting as characteristic patterns of pulmonary perfusion on lung scanning. He had a 2-week history of dyspnea and general fatigue. Echocardiography demonstrated right ventricular enlargement. Computed tomography of the chest was normal. Lung perfusion imaging showed multiple subsegmental peripheral defects, which were characteristic of tumor embolism. Ultrasonography and computed tomography of the abdomen revealed multiple enlargement of the lymph nodes. Upper gastrointestinal panendoscopy showed gastric cancer. At 10 days after admission, he suffered cardiac arrest and died despite resuscitative efforts. Histological examination revealed pulmonary arterial obstruction with tumor cells, and poorly differentiated adenocarcinoma in the stomach and lymph nodes. This case emphasizes the need to include tumor microembolism in the differential diagnosis of dyspnea, even if there is no evidence of an underlying malignant tumor.
authors.affiliation: Department of Cardiology, Otsu Red Cross Hospital, Shiga.
authors.forename: Chisaki
authors.initials: C
authors.lastname: Mizumoto
authors.forename: Masatake
authors.initials: M
authors.lastname: Hara
authors.forename: Rie
authors.initials: R
authors.lastname: Futai
authors.forename: Takayoshi
authors.initials: T
authors.lastname: Sawanishi
authors.forename: Kiichi
authors.initials: K
authors.lastname: Shirakawa
authors.forename: Hisashi
authors.initials: H
authors.lastname: Shimoyama
authors.forename: Masaru
authors.initials: M
authors.lastname: Morikawa
authors.forename: Nobuyoshi
authors.initials: N
authors.lastname: Tomioka
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Watanabe
authors.forename: Jun-ya
authors.initials: JY
authors.lastname: Tanaka
authors.forename: Osamu
authors.initials: O
authors.lastname: Nishida
authors.forename: Tatsuyoshi
authors.initials: T
authors.lastname: Saiga
authors.forename: Kunihiko
authors.initials: K
authors.lastname: Hirose
mesh_terms: D000230:Adenocarcinoma / Q000000981:diagnostic imaging / Q000556:secondary*; D003937:Diagnosis, Differential; D006801:Humans; D006976:Hypertension, Pulmonary / Q000000981:diagnostic imaging; D008168:Lung / Q000000981:diagnostic imaging*; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009360:Neoplastic Cells, Circulating / Q000473:pathology*; D011652:Pulmonary Circulation; D011877:Radionuclide Imaging; D012131:Respiratory Insufficiency / Q000175:diagnosis; D013274:Stomach Neoplasms / Q000556:secondary; D014463:Ultrasonography