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- Case Report -

An Autopsy Case of Lung Squamous Cell Carcinoma Associated with Pulmonary Tumor Thrombotic Microangiopathy

Yasuhiko Nakamura¹, Keita Sato¹, Kazutoshi Isobe¹, Keishi Sugino¹, Tsutomu Hatori², Sakae Homma^1
1Department of Respiratory Medicine, ²Department of Pathology, Toho University Omori Medical Center, Japan

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A 40-year-old man was admitted to our hospital with complaint of chronic cough in April 2010. Chest CT showed mediastinal and hilar lymphadenopathy with diffuse ground glass opacities and small nodular lesions. Hypoxemia and pulmonary hypertension rapidly developed. Biopsied specimen of left supraclavicular lymph node showed squamous cell carcinoma consistent with lung cancer (clinical stage; TxN3M0: IIIB) associated with pulmonary tumor thrombotic microangiopathy (PTTM). Although the patient received carboplatin (CBDCA)/paclitaxel (PTX) chemotherapy on 14 days after admission, he died of respiratory failure with rapidly deteriorated pulmonary hypertension, hypoxemia and disseminated intravascular coagulation (DIC) on 21 days after admission. Microscopic appearance of the autopsied lung specimens shows thromboembolic lesions in the transitional pulmonary arteries and muscular pulmonary arteries. The lumens of these pulmonary arteries are narrowed and/or completely obliterated with or without tumor emboli which corresponding to PTTM. We demonstrated a rare case of lung squamous cell carcinoma associated with PTTM.
key words: Lung squamous cell carcinoma, Pulmonary tumor thrombotic microangiopathy, Pulmonary hypertension, Disseminated intravascular coagulation

Received: May 9, 2012
Accepted: June 18, 2012

JJLC 52 (4): 402-408, 2012