An Autopsy Case of Pulmonary Tumor Thrombotic Microangiopathy Due to Rapidly Progressing Colon Cancer in a Patient with Type 2 Diabetes

Hideomi Ohguchi; Kenro Imaeda; Asami Hotta; Shouta Kakoi; Satoshi Yasuda; Yuki Shimizu; Akiko Hayakawa; Haruka Mishina; Chie Hasegawa; Shunsuke Ito; Kento Ogawa; Takashi Yagi; Hiroyuki Koyama; Tomohiro Tanaka; Hiroyuki Kato; Satoru Takahashi; Takashi Joh

doi:10.2169/internalmedicine.0204-17

CASE REPORTS

An Autopsy Case of Pulmonary Tumor Thrombotic Microangiopathy Due to Rapidly Progressing Colon Cancer in a Patient with Type 2 Diabetes

Hideomi Ohguchi, Kenro Imaeda, Asami Hotta, Shouta Kakoi, Satoshi Yasuda, Yuki Shimizu, Akiko Hayakawa, Haruka Mishina, Chie Hasegawa, Shunsuke Ito, Kento Ogawa, Takashi Yagi, Hiroyuki Koyama, Tomohiro Tanaka, Hiroyuki Kato, Satoru Takahashi, Takashi Joh

Author information

Hideomi Ohguchi
Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Japan
Kenro Imaeda
Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Japan
Asami Hotta
Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Japan
Shouta Kakoi
Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Japan
Satoshi Yasuda
Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Japan
Yuki Shimizu
Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Japan
Akiko Hayakawa
Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Japan
Haruka Mishina
Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Japan
Chie Hasegawa
Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Japan
Shunsuke Ito
Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Japan
Kento Ogawa
Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Japan
Takashi Yagi
Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Japan
Hiroyuki Koyama
Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Japan
Tomohiro Tanaka
Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Japan
Hiroyuki Kato
Department of Experimental Pathology and Tumor Biology, Nagoya City University Graduate School of Medical Sciences, Japan
Satoru Takahashi
Department of Experimental Pathology and Tumor Biology, Nagoya City University Graduate School of Medical Sciences, Japan
Takashi Joh
Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Japan

Keywords: pulmonary tumor thrombotic microangiopathy, dyspnea, colon cancer, signet-ring cell carcinoma, type 2 diabetes, autopsy

JOURNAL OPEN ACCESS

2018 Volume 57 Issue 17 Pages 2533-2539

DOI https://doi.org/10.2169/internalmedicine.0204-17

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Abstract

We herein describe a case of pulmonary tumor thrombotic microangiopathy (PTTM) with rapidly progressing colon cancer. A 61-year-old man who had been receiving treatment for type 2 diabetes mellitus for 3 years was hospitalized due to critical hypoxemia. Computed tomography, which had not shown any abnormalities 3 months previously, revealed a tumor in the ascending colon, multiple nodules in the liver, and the absence of any lung abnormalities. On day 3 of hospitalization, a sudden onset of severe dyspnea and tachycardia occurred, followed by death. Autopsy revealed microscopic metastatic tumor emboli in multiple pulmonary vessels with fibrin thrombus and intimal proliferation, which led to a diagnosis of PTTM.

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