Pulmonary Tumor Thrombotic Microangiopathy Due to Gastric Cancer Diagnosed Antemortem by a Cytological Examination of Aspirated Pulmonary Artery Blood

Figures

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  Figure 1.. EGD images at the first medical examination and pathological examination of the biopsy specimen. a: Gastric ulcer in the angle of the stomach. b: Moderately to poorly differentiated adenocarcinoma.

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  Figure 2.. Contrast-enhanced CT at the first examination. a: Swelling of the regional lymph node. b: Metastatic lung tumor in the right robe. c: Bone scintigraphy showing numerous whole-body bone metastases.

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  Figure 3.. Echocardiography at the time of consultation for a further examination of breathlessness. a: Dilated right ventricle with a compressed left ventricle at the diastolic phase (short-axis view). b: Estimated right ventricular systolic pressure of 67 mmHg.

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  Figure 4.. Ventilation-perfusion scintigraphy on admission. a: Perfusion scintigraphy demonstrating a cuneiform defect of peripheral the pulmonary artery. b: Ventilation scintigraphy showing normal ventilation competence.

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  Figure 5.. a: Pulmonary angiogram showing no thromboembolism. b: Cytologically revealed adenocarcinoma in blood aspirated from the pulmonary artery.