Images in Clinical Medicine
An Unusual Case of Pulmonary Embolism
N Engl J Med 2005; 352:1578April 14, 2005
- Article
A 33-year-old woman had dyspnea for six months, with intermittent fever. She was admitted to the hospital with worsening dyspnea, hypoxia, and patchy bilateral pulmonary consolidations. Computed tomography showed large, central pulmonary filling defects (Panel A, arrows). The patient was treated with anticoagulation and antibiotics. Her condition deteriorated, and she received an intravenous thrombolytic agent, with no improvement. She then underwent urgent pulmonary thromboendarterectomy, during which she was found to have pale, lobulated tissue completely filling both pulmonary arteries. A complete resection was performed, but a reperfusion lung injury developed, and the patient died. Histologic examination of the resected specimen showed a pleomorphic sarcoma (Panel B). At autopsy, the primary tumor site was found to be in the inferior vena cava. The tumor had embolized to the pulmonary artery and grown in situ to form the casts shown.
Tom Routledge, M.R.C.S.
David Jenkins, F.R.C.S.
Papworth Hospital, Papworth Everard, Cambridge, United Kingdom- Citing Articles (1)
Citing Articles
1
Herre J. Reesink, Onno D. F. Henneman, Otto M. Delden, Jules D. Biervliet, Jaap J. Kloek, Jim A. Reekers, Paul Bresser. (2007) Pulmonary Arterial Stent Implantation in an Adult with Williams Syndrome. CardioVascular and Interventional Radiology 30:4, 782-785
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