Microscopic pulmonary tumor embolism causing subacute cor pulmonale

A difficult antemortem diagnosis

R. W. Schriner, Jay H Ryu, W. D. Edwards

Research output: Contribution to journalArticle

109 Citations (Scopus)

Abstract

Microscopic pulmonary tumor embolism is difficult to diagnose. The most common initial clinical symptom is subacute progressive dyspnea, and the initial laboratory evaluation typically shows hypoxemia in a patient with clear lung fields on a chest roentgenogram. Another distinguishing feature may be hepatic abnormalities. In general, pulmonary angiography discloses no evidence of emboli, but multiple subsegmental peripheral perfusion defects are noted on ventilation-perfusion lung scans. The diagnosis of microscopic pulmonary tumor embolism can be confirmed by open-lung or transbronchial lung biopsy or by microvascular pulmonary cytology, a less invasive procedure that could be performed at the time of pulmonary angiography. Herein we describe two patients with unsuspected microscopic pulmonary tumor embolism that eventuated in subacute cor pulmonale and death. These cases illustrate the characteristic findings of this entity and emphasize the need for early diagnosis.

Original languageEnglish (US)
Pages (from-to)143-148
Number of pages6
JournalMayo Clinic Proceedings
Volume66
Issue number2
StatePublished - 1991
Externally publishedYes

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Circulating Neoplastic Cells
Pulmonary Heart Disease
Pulmonary Embolism
Lung
Angiography
Perfusion
Embolism
Dyspnea
Ventilation
Cell Biology
Early Diagnosis
Thorax
Biopsy
Liver

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Microscopic pulmonary tumor embolism causing subacute cor pulmonale : A difficult antemortem diagnosis. / Schriner, R. W.; Ryu, Jay H; Edwards, W. D.

In: Mayo Clinic Proceedings, Vol. 66, No. 2, 1991, p. 143-148.

Research output: Contribution to journalArticle

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