The Successful Diagnosis of Pulmonary Tumor Embolism Caused by Gastric Cancer Through Antemortem Transbronchial Lung Biopsy: an Autopsy Case

Abstract

Background. Pulmonary tumor embolism is difficult to diagnose before death. However, a few cases have suggested the possibility of improvement in the antemortem diagnosis and prognosis of pulmonary tumor embolism. It is therefore important to perform a biopsy if pulmonary tumor embolism is suspected. Case. A 55-year-old woman was referred to our department due to chronic cough and dyspnea, which had been worsening over a period of several months. She was admitted after chest CT showed bilateral diffuse pulmonary ground glass appearance. This was followed by a transbronchial lung biopsy that confirmed adenocarcinoma. Furthermore, the coexistence of carcinoma and pulmonary hypertension was identified. Thus, she was clinically diagnosed with pulmonary tumor embolism. Chemotherapy was planned, but she couldn't receive the treatment as her symptoms progressed rapidly leading to her death on the 18th day after admission. The autopsy report of the patient revealed gastric cancer with pulmonary tumor embolism. Conclusion. It is important to diagnose pulmonary tumor embolism pathologically, as this might help to improve the prognosis. We therefore concluded that transbronchial lung biopsy might be useful for the diagnosis of pulmonary tumor embolism.