Causes and presenting features of pulmonary infarctions in 43 cases identified by surgical lung biopsy

Joseph G. Parambil, C. Dilara Savci, Henry D. Tazelaar, Jay H Ryu

Research output: Contribution to journalArticle

24 Citations (Scopus)

Abstract

Background: Although pulmonary infarction is usually associated with pulmonary thromboembolism, it can occur with other disorders such as vasculitis, angioinvasive infections, sickle-cell disease, tumor embolism, and pulmonary torsion. Study objective: To identify causes and presenting features of pulmonary infarctions diagnosed by surgical biopsy in a consecutive series of patients encountered at a single institution. Design: Retrospective review. Setting: Tertiary care, referral medical center. Patients: Forty-three patients with pulmonary infarction identified on surgical lung biopsy over a period of 7 years, January 1996 through December 2002. Results: The median age of these 43 patients was 55 years (range, 22 to 85 years); 17 patients (40%) were women, and 26 patients (60%) were men. Thirty-five patients (81%) had a smoking history. Twenty-eight patients (65%) presented with solitary or multiple lung nodules/masses of undetermined etiology. The underlying cause was identifiable in 31 cases (72%) based on a review of clinical, laboratory, radiologic, and histopathologic data. The two most common causes were pulmonary thromboembolism (18 cases, 42%) and pulmonary infections (5 cases, 12%). Thromboembolic pulmonary infarctions typically presented as solitary or multiple nodules located in the subpleural regions. Other causes included diffuse alveolar damage in two cases (5%), pulmonary torsion in two cases (5%), and one case each of lung cancer, amyloidosis, embolotherapy, and catheter embolism. In 12 cases (28%), the underlying cause was not directly identifiable but was probably due to previous pulmonary thromboembolism. Conclusion: We conclude that although pulmonary thromboembolism is the most common cause of pulmonary infarction identified by surgical lung biopsy, a variety of other causes are clinically encountered, including infections, inflammatory or infiltrative lung diseases, pulmonary torsion, malignancy, and nonthrombotic embolism. Pulmonary infarction should be considered in the differential diagnosis of peripheral lung nodules or masses.

Original languageEnglish (US)
Pages (from-to)1178-1183
Number of pages6
JournalChest
Volume127
Issue number4
DOIs
StatePublished - Apr 2005

Fingerprint

Pulmonary Infarction
Biopsy
Lung
Pulmonary Embolism
Embolism
Infection
Therapeutic Embolization
Circulating Neoplastic Cells
Sickle Cell Anemia
Amyloidosis
Tertiary Healthcare
Vasculitis
Lung Diseases
Lung Neoplasms
Differential Diagnosis
Referral and Consultation
Catheters
Smoking
History

Keywords

  • Lung biopsy
  • Lung torsion
  • Pulmonary embolism
  • Pulmonary infarction

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

Causes and presenting features of pulmonary infarctions in 43 cases identified by surgical lung biopsy. / Parambil, Joseph G.; Savci, C. Dilara; Tazelaar, Henry D.; Ryu, Jay H.

In: Chest, Vol. 127, No. 4, 04.2005, p. 1178-1183.

Research output: Contribution to journalArticle

Parambil, Joseph G. ; Savci, C. Dilara ; Tazelaar, Henry D. ; Ryu, Jay H. / Causes and presenting features of pulmonary infarctions in 43 cases identified by surgical lung biopsy. In: Chest. 2005 ; Vol. 127, No. 4. pp. 1178-1183.
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