Fatal acute pulmonary hypertension caused by pulmonary tumour thrombotic microangiopathy

Int J Cardiol. 2008 Feb 20;124(1):e11-3. doi: 10.1016/j.ijcard.2006.11.162. Epub 2007 Mar 8.


Pulmonary tumour thrombotic microangiopathy (PTTM) presents as acute pulmonary hypertension and sudden cardiovascular collapse in individuals with adenocarcinoma, usually of the stomach. The illness follows a fulminant course often before the adenocarcinoma has become clinically apparent. Frequently the diagnosis is made only at necropsy. The diagnosis can be made by pulmonary microvascular cytology, obtained through a wedged pulmonary artery catheter. No treatment has thus far been found to be of benefit. We present a typical case in which the diagnosis was not reached before death despite multiple investigations and review the literature.

Publication types

  • Case Reports
  • Letter

MeSH terms

  • Adenocarcinoma / complications
  • Adenocarcinoma / secondary*
  • Adult
  • Diagnosis, Differential
  • Echocardiography
  • Electrocardiography
  • Fatal Outcome
  • Humans
  • Hypertension, Pulmonary / diagnosis
  • Hypertension, Pulmonary / etiology*
  • Lung / blood supply*
  • Lung / pathology
  • Lung Neoplasms / complications
  • Lung Neoplasms / secondary*
  • Male
  • Microcirculation / pathology
  • Stomach Neoplasms / pathology
  • Thrombosis / diagnosis
  • Thrombosis / etiology*
  • Tomography, X-Ray Computed