A case of pulmonary tumor embolism presenting with an initial manifestation of urothelial carcinoma
Hiroshi Fujiwara1) Hiroshi Katsura2)3) Masaki Suemura1)
1)Department of General Internal Medicine 2)Department of Surgery, Nissay Hospital 3)Department of Thoracic Surgery, Osaka Prefectural Medical Center for Respiratory and Allergic Diseases
A 64-year-old man presented with fever, chest pain, and bloody sputum. Chest computed tomography showed multiple, irregularly shaped infiltrative shadows in the subpleural regions of both lung fields. Out of the 6 sputum cytology specimens, only one specimen suggested malignancy. Furthermore, no malignant cells were detected in the bronchoalveolar lavage fluid. A video-assisted lung biopsy yielded a diagnosis of pulmonary tumor embolism was made. The primary lesion of this pulmonary metastatic cancer was urothelial carcinoma, which was not detected by contrast-enhanced computed tomography of the abdomen. This case is particularly unusual because it is difficult to establish an ante-mortem diagnosis of pulmonary tumor embolism, and there have been only a few previous reports regarding pulmonary tumor embolism from a urothelial tumor.
Pulmonary tumor embolism Multiple infiltrative shadows in the subpleural regions of the both lung fields Video-assisted thoracoscopic surgery Urothelial carcinoma
Received 平成17年8月22日
JJRS, 44(7): 504-510, 2006