Key result
Pulmonary tumour embolism and lymphangitis carcinomatosa from a carcinoma of unknown origin caused fatal acute right ventricular strain mimicking pulmonary embolism in a 52-year-old man.
Why the study?
Pulmonary tumour embolism and lymphangitis carcinomatosa are complications of malignancy that can mimic the clinical presentation of pulmonary embolism.
Case Report (n=1)
Pulmonary tumour embolism and lymphangitis carcinomatosa should be considered as differential diagnoses in patients with acute right ventricular strain, dyspnoea, and positive D-dimer when CTPA shows no signs of pulmonary embolism.
Alerts clinicians to tumor embolism as fatal PE mimic; hypothesis-generating for diagnostic vigilance in unknown primaries.
BACKGROUND: Pulmonary tumour embolism and lymphangitis carcinomatosa are complications of malignancy that may mimic the clinical presentation of pulmonary embolism. CASE PRESENTATION: We present the case of a 52-year-old male patient with acute-onset right ventricular strain and dyspnoea with elevated D-dimer and without signs of pulmonary embolism on computed tomography pulmonary angiogram (CTPA) and ventilation/perfusion scintigraphy. The patient died eleven days after initial presentation. The diagnosis of pulmonary tumour embolism and lymphangitis carcinomatosa due to carcinoma of unknown origin was made post-mortem by immunohistochemical examination. CONCLUSION: Pulmonary tumour embolism and lymphangitis carcinomaosa are complications of malignancy and potential causes of acute right ventricular strain. Radiological signs are unspecific and the clinical course usually fatal. These differential diagnoses should be considered in patients with acute right ventricular strain, dyspnoea and positive D-dimer if there are no signs of pulmonary embolism on CTPA.
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Engel-Morton et al. (2022) conducted a case report in Pulmonary tumour embolism and lymphangitis carcinomatosa (n=1). Pulmonary tumour embolism and lymphangitis carcinomatosa was evaluated on Clinical outcome. Pulmonary tumour embolism and lymphangitis carcinomatosa from a carcinoma of unknown origin caused fatal acute right ventricular strain mimicking pulmonary embolism in a 52-year-old man.
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