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Pulmonary Tumor Thrombotic Microangiopathy Diagnosed by Autopsy in Thymic Adenocarcinoma Patient
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A4011 - Pulmonary Tumor Thrombotic Microangiopathy Diagnosed by Autopsy in Thymic Adenocarcinoma Patient
Author Block: R. Tsugitomi, H. Kanemura, R. Imai, K. Ishii, K. Okafuji, A. Kitamura, Y. Tomishima, T. Jinta, N. Nishimura, T. Tamura; Division of Pulmonary Medicine, Thoracic Center, St Luke's International Hospital, Tokyo, Japan.
Pathological type of thymic cancers are usually squamous cell carcinomas and thymic adenocarcinoma is very rare. Pulmonary tumor thrombotic microangiopathy (PTTM) is a rare complication of malignant tumor of which pathological type are almost all adenocarcinomas. Here we report a thymic adenocarcinoma patient diagnosed with PTTM at an autopsy.
A 70-year-old female patient was revealed that she had an over 20mm nodule in anterior mediastinum and multiple lung nodules by computed tomography scan. Resection of anterior mediastinum and lung nodules led to a pathological diagnois of thymic adenocarcinoma and its lung metastasis. After first line chemotherapy, we followed her with a palliative care and no cancer treatment because she required the follow up. After one and half year, she needed long term oxygen therapy(LTOT) because of lung metastasis and pulmonary lymphangitis progression. Two weeks after starting LTOT, she was admitted to our institution with severe dyspnea exacerbated in two days and she died within a day after admission. The autopsy finding revealed obliterations of small pulmonary arteries by fibro-granulation and thrombus with carcinoma. The finding was consistent with PTTM.Best of our knowledge , because there are no reports of PTTM with thymic cancer, we consider this case to be a valuable report.
Author Block: R. Tsugitomi, H. Kanemura, R. Imai, K. Ishii, K. Okafuji, A. Kitamura, Y. Tomishima, T. Jinta, N. Nishimura, T. Tamura; Division of Pulmonary Medicine, Thoracic Center, St Luke's International Hospital, Tokyo, Japan.
Pathological type of thymic cancers are usually squamous cell carcinomas and thymic adenocarcinoma is very rare. Pulmonary tumor thrombotic microangiopathy (PTTM) is a rare complication of malignant tumor of which pathological type are almost all adenocarcinomas. Here we report a thymic adenocarcinoma patient diagnosed with PTTM at an autopsy.
A 70-year-old female patient was revealed that she had an over 20mm nodule in anterior mediastinum and multiple lung nodules by computed tomography scan. Resection of anterior mediastinum and lung nodules led to a pathological diagnois of thymic adenocarcinoma and its lung metastasis. After first line chemotherapy, we followed her with a palliative care and no cancer treatment because she required the follow up. After one and half year, she needed long term oxygen therapy(LTOT) because of lung metastasis and pulmonary lymphangitis progression. Two weeks after starting LTOT, she was admitted to our institution with severe dyspnea exacerbated in two days and she died within a day after admission. The autopsy finding revealed obliterations of small pulmonary arteries by fibro-granulation and thrombus with carcinoma. The finding was consistent with PTTM.Best of our knowledge , because there are no reports of PTTM with thymic cancer, we consider this case to be a valuable report.
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