title: Pseudo pulmonary embolism in cancer patients: a new clinical syndrome.
abstract: To characterize the clinical features of oncology patients presenting with shortness of breath mistakenly diagnosed at first with pulmonary emboli, but later found instead to have extrinsic compression of the pulmonary artery or its tributaries by tumor. Medical charts and computed tomography (CT) angiographies of these patients were reviewed retrospectively. In a 7-year period, 11 patients from a single institute were identified. Five patients were excluded as they had a pleural and pericardial effusion that by itself could result in dyspnea. All had varied solid tumors and none had lymphoma. In three of six patients, an increased ratio between right and left ventricle was detected by CT angiography; however, in contradistinction to patients with pulmonary emboli, this was not found to be associated with short survival. The term 'pseudo pulmonary emboli' is suggested to describe this phenomenon. Anticoagulant treatment to avoid in-situ pulmonary artery thrombosis may be considered; however, misdiagnosis of pulmonary embolism may delay the appropriate treatment with chemotherapy, biological therapy, and radiotherapy.
authors.affiliation: aInstitute of Thrombosis and Hemostasis, Sheba Medical Center, Tel HaShomer bSackler Faculty of Medicine, Tel Aviv University, Tel Aviv cOncology Department dDepartment of Internal Medicine 'D' eDiagnostic Imaging Department, Sheba Medical Center, Tel HaShomer, Israel.
authors.forename: Ophira
authors.initials: O
authors.lastname: Salomon
authors.forename: Yasmin
authors.initials: Y
authors.lastname: Leshem
authors.forename: Iris
authors.initials: I
authors.lastname: Gluck
authors.forename: Ehud
authors.initials: E
authors.lastname: Grossman
authors.forename: Sara
authors.initials: S
authors.lastname: Apter
authors.forename: Eli
authors.initials: E
authors.lastname: Konen
mesh_terms: D000328:Adult; D000925:Anticoagulants / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000401:mortality / Q000473:pathology; D003251:Constriction, Pathologic / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000401:mortality / Q000473:pathology; D003937:Diagnosis, Differential; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D008168:Lung / Q000098:blood supply / Q000000981:diagnostic imaging / Q000473:pathology*; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000401:mortality / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011651:Pulmonary Artery / Q000000981:diagnostic imaging / Q000473:pathology*; D011655:Pulmonary Embolism / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000473:pathology; D011859:Radiography; D012189:Retrospective Studies; D016019:Survival Analysis; D013577:Syndrome; D013927:Thrombosis / Q000000981:diagnostic imaging / Q000473:pathology / Q000517:prevention & control; D020257:Ventricular Remodeling
chemical_list: D000925:Anticoagulants