A Long-term Survival Case of Pulmonary Tumor Thrombotic Microangiopathy due to Gastric Cancer Confirmed by the Early Diagnosis based on a Transbronchial Lung Biopsy

Takeshi Imakura; Toshifumi Tezuka; Mami Inayama; Ryota Miyamoto; Akane Abe; Kanako Otsuka; Seiji Yoshida; Eiji Kudo; Takashi Haku

doi:10.2169/internalmedicine.3630-19

CASE REPORTS

A Long-term Survival Case of Pulmonary Tumor Thrombotic Microangiopathy due to Gastric Cancer Confirmed by the Early Diagnosis based on a Transbronchial Lung Biopsy

Takeshi Imakura, Toshifumi Tezuka, Mami Inayama, Ryota Miyamoto, Akane Abe, Kanako Otsuka, Seiji Yoshida, Eiji Kudo, Takashi Haku

Author information

Takeshi Imakura
Department of Respiratory Medicine, Tokushima Prefectural Central Hospital, Japan
Toshifumi Tezuka
Department of Respiratory Medicine, Tokushima Prefectural Central Hospital, Japan
Mami Inayama
Department of Respiratory Medicine, Tokushima Prefectural Central Hospital, Japan
Ryota Miyamoto
Department of Respiratory Medicine, Tokushima Prefectural Central Hospital, Japan
Akane Abe
Department of Respiratory Medicine, Tokushima Prefectural Central Hospital, Japan
Kanako Otsuka
Department of Gastroenterology, Tokushima Prefectural Central Hospital, Japan
Seiji Yoshida
Department of Respiratory Medicine, Tokushima Prefectural Central Hospital, Japan
Eiji Kudo
Department of Pathology, Tokushima Prefectural Central Hospital, Japan
Takashi Haku
Department of Respiratory Medicine, Tokushima Prefectural Central Hospital, Japan

Keywords: pulmonary tumor thrombotic microangiopathy, transbronchial lung biopsy, gastric cancer, angiogenesis inhibitor

JOURNAL OPEN ACCESS

2020 Volume 59 Issue 13 Pages 1621-1627

DOI https://doi.org/10.2169/internalmedicine.3630-19

Details

Abstract

Pulmonary tumor thrombotic microangiopathy (PTTM) is an acute, progressive, and fatal disease. PTTM manifests as subacute respiratory failure with pulmonary hypertension, progressive right-sided heart failure, and sudden death. An antemortem diagnosis of PTTM is very difficult to obtain, and many patients die within several weeks. We herein report a case of PTTM diagnosed based on a transbronchial lung biopsy. In this case, we finally diagnosed PTTM due to gastric cancer because of its histological identity. The patient was administered chemotherapy, including angiogenesis inhibitors, against gastric cancer at an early age and survived for a long time.

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