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Abstract: Poster Presentations |

Causes of Pulmonary Infarctions: Analysis of 43 Surgically Resected Cases FREE TO VIEW

Joseph G. Parambil, MD*
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Mayo Clinic, Rochester, MN


Chest


Chest. 2004;126(4_MeetingAbstracts):877S. doi:10.1378/chest.126.4_MeetingAbstracts.877S-a
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Abstract

PURPOSE:  To identify potential causes of pulmonary infarcts, we identified 43 such cases diagnosed by surgical lung biopsy over a period of seven years, January 1996 through December 2002.

METHODS:  Patients with pulmonary infarctions diagnosed by surgical lung biopsy at Mayo Medical Center, Rochester, MN were identified by a computer-assisted search of medical records.

RESULTS:  For the purpose of identifying potential causes of pulmonary infarcts, we identified 43 such cases diagnosed by surgical lung biopsy over a period of seven years, January 1996 through December 2002. Histopathologic changes of pulmonary infarction were identified in the resected lung specimen in all cases. The median age of these patients was 55 years (range 22 years to 85 years); 17 (40%) were women and 26 (60%) were men. Thirty-five patients (81%) had a smoking history. An underlying malignancy was present in 17 patients (40%). The underlying causes were identifiable in 32 cases (74%) based on review of clinical, laboratory, radiologic and histopathologic data. These causes included pulmonary thromboembolism in 17 cases (40%), pulmonary infection in 6 cases (14%), non-infectious inflammatory lung disease in 4 cases (9%), pulmonary torsion in 2 cases (5%), iatrogenic causes in 2 cases (5%), and tumor embolism in 1 case (2%). In 11 cases (26%), the underlying causes were not directly identifiable but were probably due to previous pulmonary thromboembolism.

CONCLUSION:  We conclude that although pulmonary thromboembolism is the commonest cause of pulmonary infarction, a variety of other causes exist including angioinvasive infections, infective endocarditis, inflammatory lung diseases, pulmonary torsion, tumor or foreign body embolism, and pulmonary artery catheter deployment.

CLINICAL IMPLICATIONS:  Although pulmonary thromboembolism is the commonest cause of pulmonary infarction a thorough review of clinical, laboratory, radiologic and histopathologic data is required to identify other potential causes. Based on our data we also feel that investigations for venous thromboembolism should be performed on all patients with a surgical biopsy specimen showing pulmonary infarction.

DISCLOSURE:  J.G. Parambil, None.

Wednesday, October 27, 2004

12:30 PM- 2:00 PM


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