title: [An Autopsy Case of Pulmonary Tumor Thrombotic Microangiopathy That Progressed Slowly during Chemotherapy for Advanced Gastric Cancer].
abstract: A man in his 50s presented to our hospital for anemia and was diagnosed with advanced gastric cancer with para-aortic lymph node metastases. He underwent gastrojejunostomy and received postoperative chemotherapy. Despite stable disease with chemotherapy, he complained of cough and respiratory discomfort and was subsequently admitted with progressive respiratory distress. Pulmonary hypertension and right-sided heart failure developed, and he died of sudden cardiopulmonary arrest 9 days after admission. An autopsy revealed widespread tumor metastasis, and he was diagnosed with pulmonary tumor thrombotic microangiopathy(PTTM)associated with gastric cancer. Although PTTM is a rare clinicopathological entity that causes severe pulmonary hypertension, it should be considered in the differential diagnosis of acute dyspnea in patients with carcinoma, regardless of clinical improvement.
authors.affiliation: Dept. of General Surgery, Southern Tohoku Research Institute for Neuroscience, Southern Tohoku General Hospital.
authors.forename: Nobuyasu
authors.initials: N
authors.lastname: Suzuki
authors.forename: Ayaka
authors.initials: A
authors.lastname: Azami
authors.forename: Yukitoshi
authors.initials: Y
authors.lastname: Todate
authors.forename: Takeshi
authors.initials: T
authors.lastname: Tada
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Waragai
authors.forename: Michitaka
authors.initials: M
authors.lastname: Honda
authors.forename: Atai
authors.initials: A
authors.lastname: Sato
authors.forename: Yoshinao
authors.initials: Y
authors.lastname: Takano
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Abe
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Teranishi
mesh_terms: D001344:Autopsy; D017809:Fatal Outcome; D005743:Gastrectomy; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000556:secondary*; D008297:Male; D008875:Middle Aged; D013274:Stomach Neoplasms / Q000188:drug therapy* / Q000473:pathology; D057049:Thrombotic Microangiopathies / Q000209:etiology*; D014057:Tomography, X-Ray Computed