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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

Original Article

Comparison of the clinical and radiologic features of acute pulmonary embolism patients with and without pulmonary infarction

Yasutaka Onishia  Tetsuji Kawamuraa  Takanori Higashinob  Nobuya Hirataa  Sayaka Takahashia  Yoko Yokoia  Sachie Kumea  Sachiko Higashinoa  Rinko Katsudaa  Shin Sasakia 

aDepartment of Respiratory Medicine, National Organization Himeji Medical Center
bDepartment of Radiology, National Organization Himeji Medical Center

ABSTRACT

The incidence of acute pulmonary thromboembolism (PTE) is increasing in Japan; however, recent studies have reported that acute PTE associated with pulmonary infarction is easily overlooked. Hence, to facilitate the early diagnosis of acute PTE with pulmonary infarction, we retrospectively investigated and compared the clinical and radiologic findings between acute PTE patients with and without pulmonary infarction. Patients with pulmonary infarction were significantly younger (median: 42.0 vs 70.5 years, p < 0.01), and the frequencies of chest or back pain and hemoptysis were significantly higher than patients without pulmonary infarction (p < 0.01). Regarding chest computed tomography (CT) findings, central lucencies were noted in 69% of patients with pulmonary infarction and occurred predominantly in the lower lobes. Of note, patients with pulmonary infarction were frequently (69%) treated with antibiotics before definite diagnoses, based on high C-reactive protein levels and infiltrations visible on chest radiographs and CT scans. In the diagnosis of acute respiratory failure, the clinical symptoms of chest or back pain and hemoptysis, and chest CT findings such as central lucencies and wedge-shaped peripheral consolidations in the lower lobes should be carefully considered.

KEYWORDS

Pulmonary thromboembolism (PTE)  Pulmonary infarction (PI)  Bacterial pneumonia  Wells score 

Received 31 Jul 2020 / Accepted 28 Sep 2020

AJRS, 10(1): 17-24, 2021

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