转移性乳腺癌合并肺肿瘤血栓性微血管病1例  

A case of metastatic breast cancer complicated by pulmonary tumor thrombotic microangiopathy

作　　者：郭文亮[1] 侯鹏[2] 谭维格[3] 雷永霞[4] 伍晓锋[1] 黄厚铨 洪城[1] Guo Wenliang;Hou Peng;Tan Weige;Lei Yongxia;Wu Xiaofeng;Huang Houquan;Hong Cheng(State Key Laboratory of Respiratory Diseases/National Clinical Research Center for Respiratory Disease,Guangzhou Institute of Respiratory Health,Department of Respiratory Medicine,The First Affiliated Hospital of Guangzhou Medical University,Guangzhou 510163,China;State Key Laboratory of Respiratory Diseases/National Clinical Research Center for Respiratory Disease,Guangzhou Institute of Respiratory Health,Department of Nuclear Medicine,The First Affiliated Hospital of Guangzhou Medical University,Guangzhou 510163,China;State Key Laboratory of Respiratory Diseases/National Clinical Research Center for Respiratory Disease,Guangzhou Institute of Respiratory Health,Department of Radiology,The First Affiliated Hospital of Guangzhou Medical University,Guangzhou 510163,China)

机构地区：[1]广州医科大学附属第一医院、广州呼吸健康研究院呼吸疾病、国家重点实验室国家呼吸系统疾病临床医学研究中心、国家呼吸医学中心呼吸与危重症医学科,广州510163 [2]广州医科大学附属第一医院、广州呼吸健康研究院呼吸疾病、国家重点实验室国家呼吸系统疾病临床医学研究中心、国家呼吸医学中心核医学科,广州510163 [3]广州医科大学附属第一医院、广州呼吸健康研究院呼吸疾病国家重点实验室、国家呼吸系统疾病临床医学研究中心、国家呼吸医学中心乳腺外科,广州510163 [4]广州医科大学附属第一医院、广州呼吸健康研究院呼吸疾病、国家重点实验室国家呼吸系统疾病临床医学研究中心、国家呼吸医学中心放射科,广州510163

出　　处：《中华结核和呼吸杂志》2023年第10期1014-1018,共5页Chinese Journal of Tuberculosis and Respiratory Diseases

基　　金：广东省自然科学基金基础与应用研究项目(2022A1515010472)。

摘　　要：肺肿瘤血栓性微血管病是一种与恶性肿瘤有关的并发症,疾病进展迅速,病死率极高,提高对该病的认识,尽早确诊和治疗成为救治本病成功的关键。广州医科大学附属第一医院呼吸与危重症医学科2021年9月26日收治1例外院转入的39岁肺动脉高压患者,患者最近1个月出现气促并进行性加重,外院多次CT肺动脉造影未见肺动脉栓塞,期间确诊乳腺癌。转入后高度考虑肺肿瘤性血栓性微血管病,给予肿瘤内分泌治疗。患者经治疗后气促好转,PET-CT提示肿瘤病灶明显改善,心脏超声提示肺动脉压力明显下降。现总结该病例的成功救治经验以供参考及借鉴。Pulmonary tumor thrombotic microangiopathy is a malignancy-related complication with rapid progression and high mortality.To improve the understanding of the disease,early diagnosis and treatment are key to successful treatment.A 39-year-old patient with pulmonary hypertension transferred from another hospital was admitted to the First Affiliated Hospital of Guangzhou Medical University on September 26,2021.The patient developed shortness of breath and progressive exacerbation over the past month.No pulmonary artery embolism was seen on computed tomography pulmonary angiography(CTPA)at the outside hospital where the breast cancer was diagnosed.Pulmonary tumor thrombotic microangiopathy was immediately considered on admission and oncological endocrine therapy was started.After treatment,the patient′s dyspnoea improved,PET-CT showed significant tumor regression,and cardiac ultrasound showed a significant decrease in pulmonary artery pressure.The successful treatment experience of this case was summarized for reference.

关 键 词：转移性乳腺癌 血栓性微血管病 肺动脉栓塞 进行性加重 肿瘤病灶 肺动脉压力 心脏超声 CT肺动脉造影 

分 类 号：R737.9[医药卫生—肿瘤] R734.2[医药卫生—临床医学]