title: A microscopic adenocarcinoma of the stomach with pulmonary tumor thrombotic microangiopathy in a 17-year-old male.
abstract: Pulmonary tumor thrombotic microangiopathy (PTTM), characterized by widespread fibrocellular intimal proliferation of the small pulmonary arteries and arterioles in patients with metastatic carcinomas, has been reported in only few cases. In childhood, gastrointestinal tumors represent less than 5% of pediatric neoplasms, and carcinomas within this subgroup have been very rarely described, in particular those arising in the stomach. We report on a case of a microscopic gastric signet-ring cell carcinoma identified by serial step sections through the entire stomach at autopsy. The patient was a 17-year-old high school student with severe dyspnea and marked pulmonary hypertension due to PTTM. Although the combination of PTTM with gastric cancer is very rare in childhood, it should be considered in the differential diagnosis of primary pulmonary hypertension and progressive respiratory failure, as indicated by a review of previously reported cases.
authors.affiliation: Department of Pathology, Kitasato University School of Medicine, 1-15-1 Kitasato, Sagamihara, Kanagawa 228-8555, Japan. mlc52923@nifty.com
authors.forename: Atsuko
authors.initials: A
authors.lastname: Hara
authors.forename: Masaaki
authors.initials: M
authors.lastname: Ichinoe
authors.forename: Taishi
authors.initials: T
authors.lastname: Ogawa
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Shiraishi
authors.forename: Isao
authors.initials: I
authors.lastname: Okayasu
mesh_terms: D000293:Adolescent; D018279:Carcinoma, Signet Ring Cell / Q000150:complications* / Q000556:secondary; D017809:Fatal Outcome; D006801:Humans; D008168:Lung / Q000098:blood supply* / Q000473:pathology; D008175:Lung Neoplasms / Q000150:complications* / Q000556:secondary; D008297:Male; D008833:Microcirculation / Q000473:pathology; D013274:Stomach Neoplasms / Q000150:complications* / Q000473:pathology; D013927:Thrombosis / Q000209:etiology* / Q000473:pathology