Antemortem diagnosis of pulmonary tumor thrombotic microangiopathy was achieved via FDG-PET and pulmonary artery cytology in a patient with metastatic adenocarcinoma, with transient biomarker improvement on imatinib and sildenafil.
Case Report (n=1)
FDG-PET and pulmonary artery blood cytology during right heart catheterization can facilitate the antemortem diagnosis of pulmonary tumor thrombotic microangiopathy.
Pulmonary hypertension in patients with advanced solid organ tumors may be secondary to a rare diagnosis of pulmonary tumor thrombotic microangiopathy. Current literature is limited to case reports, and there is no consensus on diagnosis and management. This case highlights the importance of a high degree of clinical suspicion and the role of additional work-up for pulmonary tumor thrombotic microangiopathy including fludeoxyglucose-19-positron emission tomography and cytology of pulmonary artery blood sample at the time of right-sided heart catheterization. Future studies are needed to better understand the role of pulmonary vasodilators and targeted therapies, such as platelet-derived growth factor inhibitors, and their impact on the clinical outcomes for patients with poor prognosis secondary to their cancers.
Ali et al. (Fri,) conducted a case report in Pulmonary Tumor Thrombotic Microangiopathy (n=1). Imatinib and sildenafil was evaluated on Clinical and biomarker response. Antemortem diagnosis of pulmonary tumor thrombotic microangiopathy was achieved via FDG-PET and pulmonary artery cytology in a patient with metastatic adenocarcinoma, with transient biomarker improvement on imatinib and sildenafil.