Three cases of pulmonary tumor thrombotic microangiopathy (PTTM): Challenge in antemortem diagnosis using lung perfusion blood volume images by dual-energy computed tomography

Hiroki Kamada, Hideki Ota, Yosuke Terui, Koichiro Sugimura, Shigefumi Fukui, Hiroaki Shimokawa, Kei Takase

Research output: Contribution to journalArticlepeer-review

Abstract

Pulmonary tumor thrombotic microangiopathy (PTTM) is a specific type of tumor embolism in the small and medium pulmonary arteries, leading to rapid progressive pulmonary hypertension. Antemortem diagnosis of PTTM is extremely difficult. We encountered three patients who were histopathologically or clinically diagnosed with PTTM. In all cases, lung perfused blood volume (PBV) images on dual-energy computed tomography (CT) demonstrated multiple subpleural wedge-shaped defects with no evidence of pulmonary embolism on CT pulmonary angiography. The lung PBV images demonstrated small pulmonary arterial obstruction reflecting the pathology of PTTM. Therefore, lung PBV imaging would be useful for antemortem diagnosis of PTTM.

Original languageEnglish
Article number100212
JournalEuropean Journal of Radiology Open
Volume7
DOIs
Publication statusPublished - 2020

Keywords

  • Dual-energy computed tomography (CT)
  • Lung perfused blood volume (PBV) images
  • Pulmonary hypertension
  • Pulmonary tumor thrombotic microangiopathy (PTTM)

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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