© 2003 BMJ Publishing Group Ltd & Association of Clinical Pathologists
SHORT REPORT
Pulmonary tumour microembolism clinically mimicking alveolitis
1 Department of Anatomical and Cellular Pathology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, NT, Hong Kong SAR, China
2 Department of Diagnostic Radiology and Organ Imaging, The Chinese University of Hong Kong
Correspondence to:
Correspondence to:
Dr A B W Chan
Department of Anatomical and Cellular Pathology, Chinese University of Hong Kong, Prince of Wales Hospital, Ngan Shing Street, Shatin, NT, Hong Kong SAR, China; amychan{at}cuhk.edu.hk
A 56 year old man with previously unsuspected recurrence of squamous cell carcinoma of the oesophagus presented with dyspnoea. Bronchoscopy and computed tomography suggested bronchopneumonic changes with an infectious cause. He suffered a rapidly deteriorating course and died despite active treatment, including antibiotics and mechanical ventilation. Necropsy revealed a florid pulmonary tumour microembolism mimicking alveolitis. No bronchopneumonia was seen. The emboli arose from loosely attached tumour vegetations in the tricuspid valve. In a patient with known malignancy, tumour microembolism should be considered as an uncommon cause of rapid respiratory failure, refractory to antibiotic treatment.
Keywords: pulmonary tumour microembolism; oesophagus; squamous cell carcinoma; alveolitis; computed tomography
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