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Abstract：
Pulmonary tumor embolism (PTE) and pulmonary tumor thrombotic microangiopathy (PTTM) are rare etiologies for rapidly progressive dyspnea in the setting of undiagnosed metastatic cancer. They occur most frequently in association with adenocarcinomas, with PTE being most frequently associated with hepatocellular carcinoma and PTTM being most commonly reported with gastric adenocarcinoma. Pulmonary tumor embolism and PTTM appear to be a disease spectrum where PTTM represents an advanced form of PTE. Pulmonary tumor embolism and PTTM are mostly identified postmortem during autopsy as the antemortem diagnosis remains a clinical challenge due to the rapidly progressive nature of these rare diseases. We report 2 cases of rapidly progressive respiratory failure leading to death, due to tumoral pulmonary hypertension resulting from PTE and PTTM, diagnosed postmortem. Both of the patients were middle-aged females, nonsmokers, and had a gastrointestinal source of their primary malignancy.
摘要：
在未确诊的转移性癌症中，肺肿瘤栓塞（PTE）和肺肿瘤血栓性微血管病（PTTM）是罕见的快速进行性呼吸困难的病因。它们最常与腺癌相关，PTE最常与肝细胞癌相关，PTTM最常见于胃腺癌。肺肿瘤栓塞和PTTM似乎是其中PTTM代表PTE的晚期形式的疾病谱。肺肿瘤栓塞和PTTM大多在尸检过程中被发现，因为由于这些罕见疾病的快速进展性质，死前诊断仍然是临床挑战。我们报告2例快速进展性呼吸衰竭导致死亡，由于PTE和PTTM引起的肿瘤性肺动脉高压，验尸后诊断。两名患者均为中年女性，不吸烟者,并有其原发性恶性肿瘤的胃肠道来源。
