Key result
Bronchial biopsy enables ante-mortem diagnosis of pulmonary tumor thrombotic microangiopathy in atypical presentation.
Why the study?
Pulmonary tumor thrombotic microangiopathy is a rare condition often diagnosed post-mortem and can mimic other respiratory diseases, complicating ante-mortem diagnosis.
Case Report (n=1)
Pulmonary tumor thrombotic microangiopathy can present as atypical pneumonia and may be diagnosed ante-mortem via bronchial biopsy even when the primary tumor is unknown.
Prompts consideration of PTTM in unexplained dyspnea with adenocarcinoma; leaves open prospective validation of diagnostics and management.
Pulmonary tumor thrombotic microangiopathy (PTTM) is a rare condition characterized by the presence of diffuse thrombotic microthrombi and fibrocellular intimal proliferation in the pulmonary vasculature. Its development is linked to the presence of pulmonary tumor microemboli (PTM) and should be suspected in patients with unexplained dyspnea, especially in the presence of adenocarcinoma. PTTM presents in a similar fashion to respiratory disease such as pulmonary embolism, pulmonary hypertension or pneumonia and is usually only diagnosed post-mortem. We report a case of PTTM identified ante-mortem by bronchial biopsy in an 82-year-old woman presenting with a clinical picture of atypical pneumonia. Autopsy confirmed PTTM, from an unknown primary neoplasm.
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Seppala et al. (2009) conducted a case report in Pulmonary tumor thrombotic microangiopathy (PTTM) (n=1). Bronchial biopsy was evaluated on Diagnosis of PTTM. An 82-year-old woman presenting with atypical pneumonia was diagnosed ante-mortem with pulmonary tumor thrombotic microangiopathy via bronchial biopsy, with autopsy confirming an unknown primary neoplasm.
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