Pulmonary tumor embolism
PTE is most commonly caused by mucin-secreting adenocarcinomas of the breast, lung, stomach, and colon. Other malignancies known to cause PTE include those of the renal cells, prostate, cervix, ovaries, bladder, skin, pancreas, parotid, and thyroid, or by mesothelioma, choriocarcinoma, hepatocellular carcinoma, atrial myxoma, or Wilms tumor. PTE is an end-stage manifestation of malignancy and carries a poor prognosis, perhaps due to the association with concomitant lymphangitic or metastatic carcinoma.
PTE is typically discovered in autopsy but rarely may become clinically apparent. Clinical presentation is variable. Most patients present with progressive dyspnea. Pleuritic chest pain is common. Less frequently occurring symptoms include fatigue, weight loss, cough, and hemoptysis. Tachycardia is usually apparent upon physical examination. Some features of pulmonary hypertension and cor pulmonale include increase in the pulmonic component of the second heart sound, a right ventricular lift, cyanosis, and jugular venous distention. The majority of PTE cases are detected in patients with a known malignancy; however, in rare cases, PTE may be the presenting manifestation in an occult neoplasm.
I74.9 – Embolism and thrombosis of unspecified artery
233940007 – Pulmonary tumor embolism
- Lymphangitic carcinomatosis – Tumor in the pulmonary lymphatic vessels. Presents with similar signs and symptoms and has similar evaluation and management; thus, definitively distinguishing between the two is not typically necessary.
- Septic embolism
- Fat embolism
- Amniotic fluid embolism
- Pulmonary embolism
- Coronary artery disease leading to chest pain or dyspnea
- Congestive heart failure, pneumonia, pleural effusions, myocardial infarction, and chronic obstructive pulmonary disease may cause chest pain, hypoxia, or dyspnea.
- Pulmonary infarction