Diffuse tumor microembolism : A rare cause of a high-probability perfusion scan

• Published in: Chest Vol. 111; no. 4; pp. 1122 - 1125
• Main Authors: MOORES, L. K, BURRELL, L. M, MORSE, R. W, BELGRAVE, C. H, BALINGIT, A. G
• Format: Journal Article
• Language: English
• Published: Northbrook, IL American College of Chest Physicians 01.04.1997
• Subjects: Biological and medical sciences; Breast Neoplasms - pathology; Female; Humans; Hypoxia - etiology; Lung - diagnostic imaging; Lung Neoplasms - diagnostic imaging; Lung Neoplasms - secondary; Medical sciences; Middle Aged; Neoplastic Cells, Circulating - pathology; Pneumology; Pulmonary hypertension. Acute cor pulmonale. Pulmonary embolism. Pulmonary vascular diseases; Radionuclide Imaging; Radionuclide study; Human; Radiodiagnosis; Respiratory disease; Cardiovascular disease; Scintigraphy; Malignant tumor; Microembolism; Vascular disease; Pulmonary embolism; Case study; Radiography; Pathology; Optical microscopy; Etiology; Medical imagery
• ISSN: 0012-3692; 1931-3543
• DOI: 10.1378/chest.111.4.1122

Pulmonary tumor embolism is a rare but well-documented cause of respiratory failure in patients with cancer. This entity is probably clinically underrecognized and may represent an important cause of morbidity and mortality. A typical pattern of multiple peripheral subsegmental defects on perfusion lung scanning has been described. We present a case of a unilateral near absence of perfusion in a 53-year-old woman who on autopsy was found to have diffuse tumor microembolism. As new chemotherapeutic agents are developed for the treatment of malignancies, an early diagnosis may become more important. A high-probability perfusion scan should not dissuade the clinician from pursuing further evaluation. Cytologic findings of pulmonary venous blood may be diagnostic.