Cases reported "Pulmonary Heart Disease"

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1/7. Transitional cell carcinoma manifesting as acute cor pulmonale: cause of microscopic tumor embolism.

    Acute cor pulmonale is an uncommon manifestation of microscopic pulmonary tumor embolism. We describe the case of an 84-year-old man with a history of transitional cell carcinoma (TCC) of the urinary bladder who had acute cor pulmonale and died within a few hours after the onset of dyspnea. autopsy showed that the right ventricle was dilated without hypertrophy. Microscopic examination of the lung showed that the small arteries, arterioles, and capillaries were filled with micrometastases of TCC. Microscopic pulmonary tumor embolism has rarely been reported with TCC, and to the best of our knowledge, such a fulminant course has not been previously described in the English language.
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2/7. Microscopic pulmonary tumour embolism: an unusual presentation of thymic carcinoma.

    The present report describes the first reported case of microscopic pulmonary tumour embolism (MPTE) from thymic carcinoma. The carcinoma was discovered during an autopsy in a 55-year-old man who had undergone surgery for a pilonidal sinus two weeks before presentation. Pulmonary thromboembolism was suspected. This case was unusual because MPTE has never before been associated with thymic carcinoma, MPTE was the first clinical indication of an occult malignancy, and the clinical presentation was that of sudden onset of dyspnea associated with acute cor pulmonale. The cause of death was determined to be hypoxia secondary to extrinsic compression of the right pulmonary artery and extensive tumour emboli in the small arteries, arterioles and venules of the pulmonary parenchyma. A review of the clinical presentation and diagnosis of MPTE is included.
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3/7. Subacute cor pulmonale due to tumor embolism.

    We describe a patient wih subacute cor pulmonale caused by tumor emboli in the lungs. A 64-year-old female suffering from a subacute progressive cough and shortness of breathing died of severe pulmonary hypertension seven days after admission. Neither chest CT scans nor lung perfusion scintigraphy showed any abnormal findings. Microscopic examination after an autopsy revealed diffuse intravascular tumor emboli occluding not only the small pulmonary arteries and arterioles, but also the lymphatic vessels, which were suggested to be metastases of a breast carcinoma resected five years previously. Thus, pulmonary tumor embolism should be considered in the differential diagnosis of primary pulmonary hypertension, particularly in patients with a past history of cancers.
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4/7. Fatal cor pulmonale caused by pulmonary tumor microembolism in a patient with occult gastric cancer.

    BACKGROUND: A fatal pulmonary tumor microembolism is rarely caused by an occult gastric cancer. methods AND RESULTS: We report the case of a 40-year-old woman who died after 3 days of progressive dyspnea, cough, and pulmonary hypertension. Postmortem examination demonstrated the presence of an occult diffuse-type gastric carcinoma, which had caused emboli in about 80% of small pulmonary arteries and arterioles. Despite an interatrial defect in the fossa ovalis, no parenchymal metastases were documented. CONCLUSION: Pulmonary tumor microembolism may be suspected in patients complaining of unexplained progressive dyspnea and who develop acute or subacute cor pulmonale.
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5/7. Diffuse pulmonary carcinomatous embolization: a rare and fatal manifestation of ovarian cancer.

    A 44-year-old female presented with dyspnea and lethal respiratory failure secondary to pulmonary embolic carcinomatosis as a manifestation of ovarian serous cystadenocarcinoma. Diffuse involvement of pulmonary arterioles and muscular arteries ranging from 30 to 950 microns in diameter was observed in conjunction with slight dilatation of pulmonary arteries. Vascular intraluminal changes included the presence of free clusters of malignant cells, superimposed thrombosis, varying degrees of eccentric fibromyxoid intimal proliferation with entrapped malignant cells, and luminal obliteration with neovascularization. The pathobiological aspects of this unique manifestation of ovarian neoplasia are discussed.
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6/7. Fatal pulmonary hypertension and resolving immune-complex glomerulonephritis in mixed connective tissue disease. A case report and review of the literature.

    mixed connective tissue disease (MCTD) has been characterized as a benign rheumatic syndrome with a favorable response to immunosuppressive therapy. Serious renal and pulmonary involvement are reported to be rare in MCTD. We are describing a female adolescent with MCTD in whom fatal cor pulmonale developed due to recurrent thromboembolic primary pulmonary hypertension. Death occurred after two years of therapy with prednisone and azathioprine for an immune-complex glomerulonephritis. Paramesangial and intramembranous electron-dense deposits had been identified in several glomeruli at the start of treatment. Improved renal function and apparent histologic improvement were demonstrated four months after the institution of prednisone and azathioprine therapy, and stable renal function was maintained until death. The pulmonary hypertension was progressive and apparently not altered by either the prednisone or azathioprine. At necropsy, there was no evidence of a pulmonary arteritis or vascular immune-complex deposition to account for the recurrent thromboembolic lesions in the small pulmonary arteries and arterioles. This is a clinical course not previously described in patients with MCTD and may represent an extreme of the clinical spectrum of this syndrome.
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7/7. Occult gastric cancer presenting as cor pulmonale resulting from tumor cell microembolism.

    Cor pulmonale resulting from tumor emboli is a rare presentation of gastric cancer, and only six similar cases have been reported in the English literature. We report the case of a 37-yr-old woman presenting with dyspnea who died of cor pulmonale. autopsy revealed signet cell carcinoma of te stomach with intra-abdominal metastasis and right ventricular hypertrophy. There were no macroscopic pulmonary emboli or parenchymal lesions, but more than 60% of the small pulmonary arteries and arterioles were occluded. In most vessels, fibrocellular intimal proliferation was the major finding with only a few entrapped tumor cells.
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