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Godbole RH, Saggar R, Kamangar N. Pulmonary tumor thrombotic microangiopathy: a systematic review. Pulm Circ. 2019;9(2):2045894019851000doi: 10.1177/2045894019851000.
Godbole, R. H., Saggar, R., & Kamangar, N. (2019). Pulmonary tumor thrombotic microangiopathy: a systematic review. Pulmonary circulation, 9(2), 2045894019851000. https://doi.org/10.1177/2045894019851000
Godbole, Rohit H, et al. "Pulmonary tumor thrombotic microangiopathy: a systematic review." Pulmonary circulation vol. 9,2 (2019): 2045894019851000. doi: https://doi.org/10.1177/2045894019851000
Godbole RH, Saggar R, Kamangar N. Pulmonary tumor thrombotic microangiopathy: a systematic review. Pulm Circ. 2019 Apr-Jun;9(2):2045894019851000. doi: 10.1177/2045894019851000. PMID: 31032740; PMCID: PMC6540517.
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Pulm Circ. 2019 Apr-Jun;9(2):2045894019851000. doi: 10.1177/2045894019851000.

Pulmonary tumor thrombotic microangiopathy: a systematic review.

Pulmonary circulation

Rohit H Godbole, Rajan Saggar, Nader Kamangar

Affiliations

  1. 1 Division of Pulmonary and Critical Care Medicine, University of California, Irvine, CA, USA.
  2. 2 Division of Pulmonary and Critical Care Medicine, University of California, Los Angeles David Geffen School of medicine, Los Angeles, CA, USA.
  3. 3 Division of Pulmonary and Critical Care Medicine, Olive View - UCLA Medical Center, Los Angeles, CA, USA.

PMID: 31032740 PMCID: PMC6540517 DOI: 10.1177/2045894019851000

Abstract

Pulmonary tumor thrombotic microangiopathy (PTTM) is a fatal disease process in which pulmonary hypertension (PH) develops in the setting of malignancy. The purpose of this study is to present a detailed analysis of cases of PTTM reported in literature in the hopes of achieving more ante-mortem diagnoses. We conducted a systematic review of currently published and available cases of PTTM by searching the term "pulmonary tumor thrombotic microangiopathy" on the Pubmed.gov database. Seventy-nine publications were included consisting of 160 unique cases of PTTM. The most commonly reported malignancy was gastric adenocarcinoma (94 cases, 59%). Cough and dyspnea were reported in 61 (85%) and 102 (94%) cases, respectively. Hypoxemia was reported in 96 cases (95%). Elevation in D-dimer was noted in 36 cases (95%), presence of anemia in 32 cases (84%), and thrombocytopenia in 30 cases (77%). Common findings on chest computed tomography (CT) included ground-glass opacities (GGO) in 28 cases (82%) and nodules in 24 cases (86%). PH on echocardiography was noted in 59 cases (89%) with an average right ventricular systolic pressure of 71 mmHg. Common features of PTTM that are reported across the published literature include presence of dyspnea and cough, hypoxemia, with abnormal CT findings of GGO, nodules, and mediastinal/hilar lymphadenopathy, and PH. PTTM is a universally fatal disease process and this analysis provides a detailed examination of all the available published data that may help clinicians establish an earlier diagnosis of PTTM.

Keywords: cancer; dyspnea; embolism; pulmonary hypertension

References

  1. Eur J Pediatr Surg. 2000 Feb;10(1):45-9 - PubMed
  2. Ann Diagn Pathol. 2000 Jun;4(3):154-7 - PubMed
  3. Arch Pathol Lab Med. 2001 Feb;125(2):304-5 - PubMed
  4. J Clin Invest. 2001 May;107(9):1055-61 - PubMed
  5. AJR Am J Roentgenol. 2002 Oct;179(4):897-9 - PubMed
  6. Neoplasia. 2002 Nov-Dec;4(6):465-73 - PubMed
  7. Hum Pathol. 2003 Dec;34(12):1290-8 - PubMed
  8. Pathol Int. 2005 Jan;55(1):27-31 - PubMed
  9. Pathol Res Pract. 2005;201(6):457-61 - PubMed
  10. Chest. 2006 Jan;129(1 Suppl):147S-153S - PubMed
  11. Dig Dis Sci. 2007 Feb;52(2):555-7 - PubMed
  12. J Clin Oncol. 2007 Feb 10;25(5):597-9 - PubMed
  13. Int J Cardiol. 2008 Feb 20;124(1):e11-3 - PubMed
  14. Pathol Int. 2007 Jun;57(6):383-7 - PubMed
  15. J Postgrad Med. 2009 Jan-Mar;55(1):38-40 - PubMed
  16. Clin Nucl Med. 2009 Mar;34(3):175-7 - PubMed
  17. Pathol Int. 2009 Oct;59(10):752-6 - PubMed
  18. Respiration. 2010;79(4):346-50 - PubMed
  19. J Clin Pathol. 2010 Apr;63(4):367-9 - PubMed
  20. Pathol Res Pract. 2010 Oct 15;206(10):682-9 - PubMed
  21. Am J Emerg Med. 2011 Feb;29(2):241.e3-4 - PubMed
  22. Diagn Pathol. 2011 Mar 30;6:27 - PubMed
  23. Cancer. 1990 Aug 1;66(3):587-92 - PubMed
  24. Circulation. 2011 Nov 1;124(18):1973-81 - PubMed
  25. Intern Med. 2011;50(22):2807-10 - PubMed
  26. Circulation. 2011 Nov 22;124(21):2355-61 - PubMed
  27. J Med Case Rep. 2011 Dec 12;5:575 - PubMed
  28. N Engl J Med. 2012 Jan 5;366(1):75-81 - PubMed
  29. J Pediatr. 2012 Apr;160(4):697-9 - PubMed
  30. J Cardiovasc Med (Hagerstown). 2014 Nov;15(11):828-33 - PubMed
  31. Int J Gynecol Pathol. 2012 Sep;31(5):438-42 - PubMed
  32. Oncol Lett. 2011 May;2(3):435-437 - PubMed
  33. Ann Thorac Med. 2012 Jul;7(3):168-9 - PubMed
  34. Tidsskr Nor Laegeforen. 2012 Sep 4;132(16):1877-80 - PubMed
  35. Intern Med. 2012;51(19):2767-70 - PubMed
  36. Med Mol Morphol. 2012 Dec;45(4):238-42 - PubMed
  37. Cancer Res Treat. 2012 Dec;44(4):267-70 - PubMed
  38. Virchows Arch. 2013 May;462(5):523-31 - PubMed
  39. Intern Med. 2013;52(12):1317-23 - PubMed
  40. J Thorac Dis. 2013 Jun;5(3):E107-11 - PubMed
  41. Intern Med. 2013;52(17):1927-30 - PubMed
  42. Case Rep Pulmonol. 2013;2013:259080 - PubMed
  43. Pediatr Dev Pathol. 2014 Jan-Feb;17(1):44-9 - PubMed
  44. Esophagus. 2013;10:247-251 - PubMed
  45. Heart Views. 2013 Oct;14(4):179-81 - PubMed
  46. Intern Med. 2014;53(11):1125-9 - PubMed
  47. Proc (Bayl Univ Med Cent). 2014 Jul;27(3):239-41 - PubMed
  48. J Gastric Cancer. 2014 Jun;14(2):142-6 - PubMed
  49. Case Rep Oncol. 2014 Aug 27;7(2):605-10 - PubMed
  50. Lung India. 2014 Oct;31(4):410-2 - PubMed
  51. Intern Med. 2014;53(22):2595-9 - PubMed
  52. Clin Breast Cancer. 2015 Apr;15(2):e167-70 - PubMed
  53. Medicine (Baltimore). 2014 Nov;93(24):359-63 - PubMed
  54. Case Rep Pulmonol. 2015;2015:286962 - PubMed
  55. Int Heart J. 2015;56(2):245-8 - PubMed
  56. Thorax. 2015 May;70(5):511, 513 - PubMed
  57. Am J Respir Crit Care Med. 2015 Mar 15;191(6):711-2 - PubMed
  58. Chest. 2015 May;147(5):e175-e180 - PubMed
  59. BMC Cancer. 2015 Jun 03;15:450 - PubMed
  60. Korean J Radiol. 2015 Jul-Aug;16(4):936-41 - PubMed
  61. Eur Respir J. 2015 Oct;46(4):1214-7 - PubMed
  62. J Forensic Sci. 2015 Nov;60(6):1637-9 - PubMed
  63. BMJ Case Rep. 2015 Aug 26;2015:null - PubMed
  64. Eur Heart J. 2016 Jan 1;37(1):67-119 - PubMed
  65. Clin Case Rep. 2015 Sep;3(9):735-9 - PubMed
  66. Oncol Res Treat. 2015;38(9):449-52 - PubMed
  67. Proc (Bayl Univ Med Cent). 2015 Oct;28(4):482-3 - PubMed
  68. Intern Med. 2015;54(22):2877-80 - PubMed
  69. Korean J Intern Med. 2017 Jan;32(1):190-194 - PubMed
  70. Intern Med. 2016;55(6):651-6 - PubMed
  71. Arch Bronconeumol. 2016 Dec;52(12):621-622 - PubMed
  72. Curr Opin Pulm Med. 2016 Sep;22(5):421-8 - PubMed
  73. Mayo Clin Proc. 2016 Dec;91(12):1834-1839 - PubMed
  74. BMC Cancer. 2016 Aug 22;16:666 - PubMed
  75. BMJ Case Rep. 2016 Aug 26;2016: - PubMed
  76. Ann Am Thorac Soc. 2016 Jul;13 Suppl 3:S215-21 - PubMed
  77. Ann Am Thorac Soc. 2016 Jul;13 Suppl 3:S222-39 - PubMed
  78. Intern Med. 2017;56(1):67-71 - PubMed
  79. Pathologica. 2016 Dec;108(4):160-163 - PubMed
  80. Korean J Intern Med. 2017 May;32(3):555-558 - PubMed
  81. BMJ Case Rep. 2017 Jun 28;2017:null - PubMed
  82. Pulm Circ. 2017 Oct-Dec;7(4):813-820 - PubMed
  83. Am J Case Rep. 2017 Aug 31;18:941-944 - PubMed
  84. BMJ Case Rep. 2017 Sep 7;2017:null - PubMed
  85. Am J Forensic Med Pathol. 2018 Mar;39(1):56-60 - PubMed
  86. J Med Case Rep. 2017 Dec 23;11(1):356 - PubMed
  87. Int Heart J. 2018 Mar 30;59(2):443-447 - PubMed
  88. Pathol Int. 1995 Jun;45(6):436-40 - PubMed
  89. Chest. 1993 Mar;103(3):685-92 - PubMed
  90. Am J Pathol. 1996 Jul;149(1):293-305 - PubMed
  91. Arterioscler Thromb Vasc Biol. 1996 Nov;16(11):1365-72 - PubMed
  92. AJR Am J Roentgenol. 1997 Aug;169(2):355-67 - PubMed

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