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Diffuse Tumor Microembolism : A Rare Cause of a High-Probability Perfusion Scan

Lisa K. Moores; Linda M. Burrell; Robert W. Morse; Clyde H. Belgrave; Antonio G. Balingit
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From the Departments of Medicine, Pathology, and Nuclear Medicine, Walter Reed Army Medical Center, Washington, DC; and the Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Md.


1997 by the American College of Chest Physicians


Chest. 1997;111(4):1122-1125. doi:10.1378/chest.111.4.1122
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Abstract

Pulmonary tumor embolism is a rare but well-documented cause of respiratory failure in patients with-cancer. This entity is probably clinically underrecognized and may represent an important cause of morbidity and mortality. A typical pattern of multiple peripheral subsegmental defects on perfusion lung scanning has been described. We present a case of a unilateral near absence of perfusion in a 53-year-old woman who on autopsy was found to have diffuse tumor microembolism. As new chemotherapeutic agents are developed for the treatment of malignancies, an early diagnosis may become more important. A high-probability perfusion scan should not dissuade the clinician from pursuing further evaluation. Cytologic findings of pulmonary venous blood may be diagnostic.


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