title: Fatal acute pulmonary hypertension caused by pulmonary tumour thrombotic microangiopathy.
abstract: Pulmonary tumour thrombotic microangiopathy (PTTM) presents as acute pulmonary hypertension and sudden cardiovascular collapse in individuals with adenocarcinoma, usually of the stomach. The illness follows a fulminant course often before the adenocarcinoma has become clinically apparent. Frequently the diagnosis is made only at necropsy. The diagnosis can be made by pulmonary microvascular cytology, obtained through a wedged pulmonary artery catheter. No treatment has thus far been found to be of benefit. We present a typical case in which the diagnosis was not reached before death despite multiple investigations and review the literature.
authors.forename: N G
authors.initials: NG
authors.lastname: Keenan
authors.forename: A G
authors.initials: AG
authors.lastname: Nicholson
authors.forename: P J
authors.initials: PJ
authors.lastname: Oldershaw
mesh_terms: D000230:Adenocarcinoma / Q000150:complications / Q000556:secondary*; D000328:Adult; D003937:Diagnosis, Differential; D004452:Echocardiography; D004562:Electrocardiography; D017809:Fatal Outcome; D006801:Humans; D006976:Hypertension, Pulmonary / Q000175:diagnosis / Q000209:etiology*; D008168:Lung / Q000098:blood supply* / Q000473:pathology; D008175:Lung Neoplasms / Q000150:complications / Q000556:secondary*; D008297:Male; D008833:Microcirculation / Q000473:pathology; D013274:Stomach Neoplasms / Q000473:pathology; D013927:Thrombosis / Q000175:diagnosis / Q000209:etiology*; D014057:Tomography, X-Ray Computed