CTICasesPulmonary Tumor Thrombotic Microangiopathy
Imaging findings
CT chest shows diffuse, tiny centrilobular lung nodules that correspond to micro-vessels on MIP images, with mild mediastinal/hilar lymphadenopathy. Autopsy path slides show microscopic tumor-induced in-situ thrombi and fibrocellular intimal thickening of the arterioles, secondary to a signet ring cell adenocarcinoma of the GE junction.
Key takeaways
Pulmonary tumor thrombotic microangiopathy (PTTM) is a fatal cancer-associated condition where microscopic tumor emboli trigger widespread in-situ thrombosis of the pulmonary arterioles. This leads to rapidly progressive dyspnea and severe subacute pulmonary hypertension, classically associated with gastric signet ring cell carcinoma.
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