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Abstract

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Article in Japanese

Case Report

An autopsy case of breast cancer with pulmonary tumor thrombotic microangiopathy that required differentiation from radiation pneumonitis

Kaori Sekia  Yu Kasamatsua  Kiyokazu Yoshinoyaa  Masatoshi Kadoyaa  Ai Hironakab  Masahide Yamaguchib  Kenji Kawabatac  Yoshihiro Kasamatsua 

aDepartment of Respiratory Medicine, Matsushita Memorial Hospital
bDepartment of Brest Surgery, Matsushita Memorial Hospital
cDepartment of Clinical Pathology, Matsushita Memorial Hospital

ABSTRACT

A 58-year-old woman with dry cough and progressive dyspnea on exertion in spite of various antitussive therapies, including herbal medicines in a family clinic, visited our hospital. She was receiving adjuvant chemotherapy and radiotherapy for postoperative breast cancer (pT4N3aM0, stage IIIc) six months before. She was diagnosed as drug-induced pneumonia or radiation-recall pneumonitis caused by various drugs, including herbal medicine based on the bilateral small ground-glass opacity of chest CT findings and KL-6 elevation. Two weeks after the initiation of steroid therapy, she was admitted to our hospital because of the appearance of pleural effusion; then she was diagnosed as recurrent breast cancer by immunostaining of cell-block-method specimens by chest drainage. Although her dyspnea was improved for a while after chemotherapy, she died of subacutely progressive respiratory failure on hospital day 42. Autopsy findings revealed pulmonary tumor thrombotic microangiopathy (PTTM), but radiation pneumonitis was not detected.

KEYWORDS

KL-6  Pulmonary tumor thrombotic microangiopathy  Radiation pneumonitis  Breast cancer 

Received 5 Dec 2011 / Accepted 15 Feb 2012

AJRS, 1(6): 526-530, 2012

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