Pulmonary tumor thrombotic microangiopathy of hepatocellular carcinoma: A case report and review of literature

作     者：Shinichi Morita Kenya Kamimura Hiroyuki Abe Yukari Watanabe-Mori Chiyumi Oda Takamasa Kobayashi Yoshihisa Arao Yusuke Tani Riuko Ohashi Yoichi Ajioka Shuji Terai 

作者机构：Division of Gastroenterology and HepatologyGraduate School of Medical and Dental SciencesNiigata UniversityNiigata 951-8510Japan Division of Molecular and Diagnostic PathologyNiigata University Graduate School of Medical and Dental SciencesNiigata UniversityNiigata 951-8510Japan Histopathology Core FacilityNiigata University Faculty of MedicineNiigata UniversityNiigata 951-8510Japan 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2019年第25卷第48期

页      面：6949-6958页

核心收录：

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

基　　金：Japan Society for the Promotion of Science  JSPS  (19K16553) 

主　　题：Pulmonary tumor thrombotic microangiopathy Hepatocellular carcinoma Respiratory dysfunction Prednisolone Supportive care Case report 

摘      要：BACKGROUND Pulmonary tumor thrombotic microangiopathy(PTTM)is a rare condition in patients with hepatocellular carcinoma(HCC);to date,few cases have been *** hepatic dysfunction has been focused on the later stages of HCC,the management of symptoms in PTTM is important for supportive care of the *** the better understanding of PTTM in HCC,the information of our recent case and reported cases have been *** SUMMARY A patient with HCC exhibited acute and severe respiratory *** and computed tomography of the chest revealed the multiple metastatic tumors and a frosted glass–like shadow with no evidence of infectious *** diagnosed his condition as acute respiratory distress syndrome caused by the lung metastases and involvement of the pulmonary vessels by tumor *** of prednisolone to alleviate the diffuse alveolar damages including edematous changes of alveolar wall caused by the tumor cell infiltration and ischemia showed mild improvement in his symptoms and imaging *** autopsy showed the typical pattern of PTTM in the lung with multiple *** PTTM is caused by tumor thrombi in the arteries and thickening of the pulmonary arterial endothelium leading to the symptoms of dyspnea in terminal staged ***,supportive management of symptoms is necessary in the cases with PTTM and hence we believe that the information presented here is of great significance for the diagnosis and management of symptoms of PTTM with HCC.