关键词： GGO, ground glass opacities Micronodules PTE, pulmonary tumor embolism Pulmonary tumor embolism Renal cell carcinoma Respiratory failure SpO2, peripheral oxygen saturation Surgical lung biopsy mMRC, modified Medical Research Council dyspnea scale GGO, ground glass opacities Micronodules PTE, pulmonary tumor embolism Pulmonary tumor embolism Renal cell carcinoma Respiratory failure SpO2, peripheral oxygen saturation Surgical lung biopsy mMRC, modified Medical Research Council dyspnea scale

来  源：   DOI：10.1016/j.rmcr.2022.101716   PDF(Pubmed)

Abstract：
Pulmonary tumor embolism (PTE) is difficult to diagnose before death. We report the case of a 75-year-old man with microscopic PTE of renal cell carcinoma who was diagnosed by surgical lung biopsy. He visited our hospital because of dyspnea on exertion. Chest computed tomography (CT) showed multiple micronodules and ground glass opacities. Steroid therapy was started as therapeutic diagnosis for IgG4-related pulmonary disease. However, he was admitted our hospital due to progressive respiratory failure. Pathological findings of a lung biopsy obtained by video-assisted thoracic surgery showed PTE of renal cell carcinoma without embolization of large pulmonary arteries. He received palliative medicine and died four months after the surgical lung biopsy. In cases of multiple micronodules in chest CT findings and worsened respiratory symptoms, PTE should be considered in the differential diagnosis.
摘要：
肺肿瘤栓塞（PTE）在死亡之前很难诊断。我们报告了一例75岁的男性，患有肾细胞癌的显微镜PTE，该患者经手术肺活检诊断。他因劳累呼吸困难来我院就诊。胸部计算机断层扫描（CT）显示多个微结节和毛玻璃混浊。开始类固醇治疗作为IgG4相关肺病的治疗性诊断。然而,他因进行性呼吸衰竭入院。通过电视胸腔镜手术获得的肺活检的病理结果显示，肾细胞癌的PTE没有大肺动脉栓塞。他接受了姑息治疗，并在手术肺活检后四个月死亡。在胸部CT发现多个微结节并加重呼吸道症状的情况下，在鉴别诊断中应考虑PTE。
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