title: [A case of pulmonary tumor embolism presenting with an initial manifestation of urothelial carcinoma].
abstract: A 64-year-old man presented with fever, chest pain, and bloody sputum. Chest computed tomography showed multiple, irregularly shaped infiltrative shadows in the subpleural regions of both lung fields. Out of the 6 sputum cytology specimens, only one specimen suggested malignancy. Furthermore, no malignant cells were detected in the bronchoalveolar lavage fluid. A video-assisted lung biopsy yielded a diagnosis of pulmonary tumor embolism was made. The primary lesion of this pulmonary metastatic cancer was urothelial carcinoma, which was not detected by contrast-enhanced computed tomography of the abdomen. This case is particularly unusual because it is difficult to establish an ante-mortem diagnosis of pulmonary tumor embolism, and there have been only a few previous reports regarding pulmonary tumor embolism from a urothelial tumor.
authors.affiliation: Department of General Internal Medicine, Nissay Hospital.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Fujiwara
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Katsura
authors.forename: Masaki
authors.initials: M
authors.lastname: Suemur
mesh_terms: D001706:Biopsy; D002295:Carcinoma, Transitional Cell / Q000556:secondary*; D003937:Diagnosis, Differential; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology*; D007682:Kidney Pelvis; D008168:Lung / Q000473:pathology; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary*; D008297:Male; D008875:Middle Aged; D009360:Neoplastic Cells, Circulating / Q000473:pathology*; D011655:Pulmonary Embolism / Q000175:diagnosis* / Q000000981:diagnostic imaging; D011859:Radiography; D020775:Thoracic Surgery, Video-Assisted