Pulmonary tumor embolism: a critical review of clinical, imaging, and hemodynamic features

J Thorac Imaging. 1987 Oct;2(4):4-14.


Pulmonary tumor embolism is a common finding at autopsy but is generally perceived as a difficult diagnosis to make ante mortem. After a retrospective review of 164 reported cases of pulmonary tumor embolism, we identified a typical profile of clinical, laboratory, and imaging features that may permit confident clinical diagnosis in most patients with this condition. The clinical features include a documented or suspected underlying malignancy, acute to subacute onset of dyspnea, and signs of cor pulmonale. Supportive laboratory features are hypoxemia or increased alveolar-arterial oxygen gradient, and invasive or noninvasive evidence of pulmonary artery hypertension. Typical imaging findings are normal chest radiographs; multiple, subsegmental, peripheral perfusion defects on ventilation-perfusion lung scans; and delayed filling with or without subsegmental filling defects but without a thrombus on pulmonary angiogram. Radiolabeled monoclonal antibody imaging and pulmonary microvascular cytology sampling techniques are promising diagnostic tests for early diagnosis of pulmonary tumor embolism.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Antibodies, Monoclonal
  • Diagnostic Imaging
  • Female
  • Hemodynamics
  • Humans
  • Lung / blood supply
  • Lung Neoplasms* / diagnosis
  • Lung Neoplasms* / physiopathology
  • Male
  • Microcirculation
  • Middle Aged
  • Neoplastic Cells, Circulating*


  • Antibodies, Monoclonal