This case represents the first description of diffuse alveolar hemorrhage likely caused by tumor emboli of metastatic angiosarcoma.
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Consider angiosarcoma emboli in refractory DAH; extends the differential for pulmonary hemorrhage syndromes.
A case of diffuse alveolar hemorrhage due to lung metastasis of ovarian angiosarcoma is described. A 33-year-old woman developed persistent cough and recurrent hemoptyses with resultant anemia. Chest radiograph and computerized tomography (CT) showed diffuse and patchy shadows in both lungs with nodules in the central area of the shadows. In spite of intensive care and administration of large amounts of glucocorticoids, she died of respiratory failure 5 months after the onset of her symptoms. Histological examination by both thoracoscopic biopsy and autopsy revealed diffuse tumor emboli of disseminated angiosarcoma which originated from the right ovary and diffuse alveolar hemorrhage which appeared to be caused by the tumor emboli with resultant invasion and destruction to vascular walls. This is the first description of diffuse alveolar hemorrhage probably caused by tumor emboli of metastatic angiosarcoma.
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Nara et al. (1996) studied this question.
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