Key result
A 71-year-old woman with recurrent breast cancer was diagnosed antemortem with pulmonary tumor thrombotic microangiopathy via transbronchial lung biopsy and died on the 20th hospital day.
Case Report (n=1)
No
Antemortem diagnosis of pulmonary tumor thrombotic microangiopathy (PTTM) is possible via transbronchial lung biopsy in cancer patients presenting with progressive dyspnea and right heart failure, though the prognosis remains extremely poor.
PTTM merits consideration in cancer patients with progressive dyspnea and right heart strain; single case leaves open optimal diagnostic and therapeutic strategies.
症例は71歳，女性．左乳癌（T1bN0M0）に対して乳房部分切除術を施行した．術後補助療法は拒否されたため，無治療経過観察となった．術後3年5カ月で左腋窩リンパ節再発と多発骨転移を認め，その3カ月後に呼吸困難が出現した．胸部CTでは両肺に浸潤影とすりガラス影が多発し，経気管支肺生検（transbronchial lung biopys:以下TBLB）では血管内に腫瘍塞栓像を認め，心エコーで右心負荷所見を認めた．以上から，pulmonary tumor thrombotic microangiopathy（以下PTTM）と診断したが進行性に状態が悪化し，入院20日目に死亡した．担癌患者が進行性の呼吸困難や右心不全を発症した場合には，本疾患も鑑別に挙げて精査を行う必要がある．
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FUKUSHIMA et al. (2022) conducted a case report in Breast cancer with pulmonary tumor thrombotic microangiopathy (n=1). Pulmonary tumor thrombotic microangiopathy (PTTM) was evaluated on Clinical outcome. A 71-year-old woman with recurrent breast cancer was diagnosed antemortem with pulmonary tumor thrombotic microangiopathy via transbronchial lung biopsy and died on the 20th hospital day.
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