title: Pulmonary Tumor Thrombotic Microangiopathy Caused by a Parotid Tumor: Early Antemortem Diagnosis and Long-term Survival.
abstract: Pulmonary tumor thrombotic microangiopathy (PTTM) is a high-mortality disease that is difficult to diagnose clinically. Our patient was an 80-year-old woman who came to us due to symptoms of increasing dyspnea. A clinical evaluation showed that she had hypoxemia and pulmonary arterial hypertension without any abnormalities in the major pulmonary arteries, bronchi, or alveoli. A lung perfusion scan showed multiple wedge-shaped perfusion defects. Further examination revealed adenocarcinoma in her right parotid gland with metastasis to the submandibular lymph nodes. We diagnosed her to have PTTM caused by a parotid tumor. The patient survived for 11 months with chemotherapy. An early antemortem diagnosis by minimally invasive examinations will help PTTM patients to survive longer.
authors.affiliation: Respiratory Medicine, Rakuwakai Otowa Hospital, Japan.
authors.forename: Haruka
authors.initials: H
authors.lastname: Toyonaga
authors.forename: Michiko
authors.initials: M
authors.lastname: Tsuchiya
authors.forename: Chikara
authors.initials: C
authors.lastname: Sakaguchi
authors.forename: Hitomi
authors.initials: H
authors.lastname: Ajimizu
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Nakanishi
authors.forename: Seiya
authors.initials: S
authors.lastname: Nishiyama
authors.forename: Noboru
authors.initials: N
authors.lastname: Morikawa
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Hayashi
authors.forename: Yukio
authors.initials: Y
authors.lastname: Nagasaka
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yasui
mesh_terms: D000230:Adenocarcinoma / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy*; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001344:Autopsy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000188:drug therapy* / Q000473:pathology; D009360:Neoplastic Cells, Circulating / Q000473:pathology; D010306:Parotid Gland / Q000473:pathology; D057049:Thrombotic Microangiopathies / Q000175:diagnosis* / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents