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Nuklearmedizin 1998; 37(04): 153-155
DOI: 10.1055/s-0038-1632317
Original Article
Schattauer GmbH

Pulmonary Tumor Microembolism

Tumorbedingte Lungen-Mikroembolie
R. Bennink
1   Department of Nuclear Medicine
,
E. Van Wijngaerden
2   Department of Internal Medicine, Universaity Hospital Gasthnisberg, Catholic University Leuven, Belgium
,
M. De Roo
1   Department of Nuclear Medicine
,
L. Mortelmans
1   Department of Nuclear Medicine
› Author Affiliations
Further Information

Publication History

received: 05 November 1997

Accepted after major revision 29 December 1997

Publication Date:
03 February 2018 (online)

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Summary

Pulmonary tumor embolism is an often missed antemortem diagnosis in patients with cancer and respiratory failure. Although rare, this complication is an important cause of additional morbidity. Referred for radionuclide pulmonary perfusion and ventilation scintigraphy, a typical pattern of multiple subsegmental peripheral defects on perfusion lung scanning without matching ventilation defects, suggesting a high probability for pulmonary thromboembolism, often leads to false conclusions.

We present a case of bilateral multiple subsegmental mismatched defects in lung ventilation perfusion scintigraphy, where autopsy confirmed the diagnosis of pulmonary tumor embolism, secondary to an undifferentiated ductal type adenocarcinoma of the pancreas. Pulmonary tumor embolism is an entity to keep in mind in patients treated for carcinoma presenting with (sub) acute dyspnea.

Zusammenfassung

Die tumorbedingte Lungenembolie ist eine häufig übersehene ante- mortale Diagnose bei Patienten mit Karzinom und respiratorischer Insuffizienz. Diese Komplikation ist selten, sie ist jedoch eine bedeutende Ursache einer zusätzlichen Morbidität. Bei Patienten, die zur Radio- nuklid-Perfusions- und Ventilationslungenszintigraphie überwiesen werden, findet sich ein typisches Muster mit multiplen, subsegmentalen, peripheren Defekten auf dem Perfusionslungenszintigramm ohne entsprechende Ventilationsdefekte, das auf eine hohe Wahrscheinlichkeit einer pulmonalen Thromboseembolie hinweist und häufig zu falschen Schlüssen führt.

Wir stellen einen Fall mit bilateralen, multiplen, subsegmentalen, nicht übereinstimmenden Defekten bei der Lungenventilations- und Per- fusionsszintigraphie vor, bei dem die Autopsie die Diagnose einer tumorbedingten Lungenembolie bestätigte, die auf ein undifferenziertes duktales Adenokarzinom des Pankreas zurückführbar war. Die tumorbedingte Lungenembolie ist eine Entität, an die bei Patienten, die wegen eines Karzinoms behandelt werden und sich mit (sub)akuter Dyspnoe vorstellen, gedacht werden muß.

Keywords

Lung radionuclide imaging - neoplasm circulating cells - carcinoma infiltrating duct pathology - pancreatic neoplasm’s pathology - lung neoplasm’s secondary

Schlüsselwörter

Radionuklid-Lungenszintigraphie - zirkulierende Neoplasma-Zellen - Pathologie des Ductus-infiltrierenden Karzinoms - Pathologie des Pankreas- Neoplasmas - pulmonale Neoplasma-Metastase
 

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