論文

国際誌
2020年9月

Pulmonary tumor thrombotic microangiopathy associated with extramammary Paget's disease: An autopsy case report.

Pathology international
  • Yuzo Oyama
  • ,
  • Haruto Nishida
  • ,
  • Yoshihiko Kondo
  • ,
  • Takahiro Kusaba
  • ,
  • Hiroko Kadowaki
  • ,
  • Taisuke Harada
  • ,
  • Shotaro Saito
  • ,
  • Naohiko Takahashi
  • ,
  • Tsutomu Daa

70
9
開始ページ
680
終了ページ
685
記述言語
英語
掲載種別
DOI
10.1111/pin.12980

Pulmonary tumor thrombotic microangiopathy (PTTM) is histologically characterized by micro tumor cell embolism and intimal fibrocellular proliferation of pulmonary arteries or arterioles. We report a secondary case of PTTM associated with extramammary Paget's disease (EMPD). The patient was a 72-year-old man with exertional dyspnea. Clinical examinations found he had pulmonary hypertension and multiple osteolytic lesions of vertebra. Cytological analysis of pulmonary wedge artery sample detected malignant cells and he was dead before treatment was started. Multiple tumor embolisms (>17) were identified in pulmonary arteries or arterioles at autopsy, consistent with PTTM. Metastatic nodules were found in liver and lymph node. Furthermore, disseminated carcinomatosis of the bone marrow (DCBM) was seen. Immunostaining results pointed out that tumor cells possessed mammary gland phenotype. He had 4-years history of EMPD in the left axilla without recurrence, and immunohistochemistry results were the same as the autopsy specimen. Thus, we diagnosed the primary site of PTTM to be EMPD. Our case highlights the usefulness of the recent proposed classification of PTTM, potential association between PTTM and DCBM, and the necessity for long-term follow-up in EMPD. EMPD can rarely cause PTTM to manifest as a paraneoplastic syndrome.

リンク情報
DOI
https://doi.org/10.1111/pin.12980
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/32638479
ID情報
  • DOI : 10.1111/pin.12980
  • PubMed ID : 32638479

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