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日本呼吸器学会英文誌 Respiratory Investigation
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Abstract

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Article in Japanese

Case Report

An Autopsy Case of Cor Pulmonale due to a Pulmonary Tumor Embolism as the First Clinical Manifestation of Occult Gastric Cancer

Hiroyuki Matsuda1)  Kingo Chida1)  Seiiti Miwa1)  Hideki Nakano1)  Hirofumi Kuwata1)  Kenichiro Suzuki1)  Koshi Yokomura1)  Kazuhiro Asada1)  Yutaro Nakamura1)  Naoki Inui1)  Takafumi Suda1)  Hirotoshi Nakamura1)  Yasuhisa Naito2)  Haruhiko Sugimura2) 

1)Second Division, Department of Internal Medicine, 2)First Department of Pathology, Hamamatsu
University, School of Medicine, Hamamatsu, Shizuoka 431-3192, Japan

ABSTRACT

A 47-year-old man was admitted to our hospital because of progressive dyspnea and cough. Physical examination and chest radiographs showed the signs of cor pulmonale. A lung scan using perfused radionuclide revealed multiple peripheral perfusion defects and catheterization of the right heart showed severe pulmonary hypertension. A diagnosis of severe pulmonary embolism was made. Despite intensive care with anti-coagulation therapy, the patient died on the third-hospital day. Autopsy disclosed gastric cancer in the pylorus with metastases to the regional lymph nodes. There were no macroscopic pulmonary artery emboli or parenchymal lesions, but more than 60% of the small arteries and arterioles were occluded by casts of tumor cells. Cor pulmonale due to a pulmonary tumor embolism is a rare complication of cancer. This case is particularly unusual because the embolus-caused cor pulmonale was the initial manifestation of clinically occult, but pathologically advanced, gastric cancer.

KEYWORDS

Pulmonary tumor embolism  Respiratory failure  Cor pulmonale  Gastric cancer 

Received 平成14年1月10日

JJRS, 40(11): 910-914, 2002

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