title: Ante-mortem diagnosis of pulmonary tumour thrombotic microangiopathy in a patient with unrecognised extramammary Paget's disease.
abstract: Pulmonary tumour thrombotic microangiopathy (PTTM) resulting in fatal pulmonary hypertension is a rare complication of malignancy. Patients with PTTM generally suffer rapid deterioration of hypoxaemia, and a diagnosis is often only made at autopsy. We report a case of extramammary Paget's disease associated with PTTM. An ante-mortem diagnosis was made based on cytology of blood aspirated from a pulmonary artery catheter in a wedged position. Together with a review of the literature, this case highlights the potential diagnostic value of blood cytology in patients with cancer with rapidly progressing pulmonary hypertension.
authors: Department of Internal Medicine, Ippan Zaidan Hojin Kanagawa-ken Keiyukai, Yokohama, Kanagawa, Japan.
authors: Aya
authors: A
authors: Banno
authors: Department of Internal Medicine, Ippan Zaidan Hojin Kanagawa-ken Keiyukai, Yokohama, Kanagawa, Japan.
authors: Keijiro
authors: K
authors: Chiba
authors: Department of Dermatology, Ippan Zaidan Hojin Kanagawa-ken Keiyukai, Yokohama, Kanagawa, Japan.
authors: Hiroko
authors: H
authors: Kasai
authors: Department of Internal Medicine, Ippan Zaidan Hojin Kanagawa-ken Keiyukai, Yokohama, Kanagawa, Japan.
authors: Keiichi
authors: K
authors: Nagami
mesh_terms: D000368:Aged; D004417:Dyspnea / Q000209:etiology; D017809:Fatal Outcome; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging / Q000473:pathology*; D008297:Male; D010145:Paget Disease, Extramammary / Q000150:complications / Q000175:diagnosis*; D011859:Radiography; D012611:Scrotum / Q000473:pathology*; D057049:Thrombotic Microangiopathies / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology