2005 Volume 38 Issue 8 Pages 1306-1311
A 52-year-old man transferred to our hospital for suspected gastric cancer with epigastralgia, weight loss, and appetite loss was found in gastrointestinal fiber to have type 4 gastric cancer. Gastric biopsy showed signet ring cell carcinoma. When scheduled for neoajuvant chemotherapy, he reported exertional dyspnea and pre-sented with hypoxemia and hypocapnia. Chest CT showed diffuse granular shadows and thickened bron-covessel bundles. Lung perfusion study showed stringy defects indicating the presence of multiple microem-bolisms. On hospital day 8, dyspnea suddenly worsened, and chest CT showed increased macular shadows. He died of respiratory failure on hospital day 10. Necropsy of the lung showed fibrocellular intimal proliferation, organized thrombi, and recanalization in small pulmonary arteries compatible with pulmonary tumor throm-botic microangiopathy (PTTM).
