Clinical suspicion of autopsy-proven thrombotic and tumor pulmonary embolism in cancer patients

doi:10.1016/0002-8703(87)90548-5

American Heart Journal

Volume 114, Issue 6, December 1987, Pages 1432-1435

https://doi.org/10.1016/0002-8703(87)90548-5 Get rights and content

Abstract

Cancer patients are prone to both thrombotic and tumor pulmonary embolism (PE). To identify similarities and differences in their clinical features, we reviewed all autopsies from 1978 to 1982 at Brigham and Women's Hospital and the Dana Farber Cancer Institute. Of 73 patients with solid mallgnant tumors and PE, 56 had major thrombotic PE and 17 had major tumor embolism to the lungs. Of the 56 with cancer and thrombotic PE, 25 (45%) had the correct diagnosis suspected antemortem. By contrast, only 1 of 17 (6%) patients with tumor embolism was diagnosed correctly antemortem (p = 0.005). Most presenting symptoms, signs, laboratory values, and associated conditions were not markedly different in patients with thrombotic PE and tumor embolism. These findings indicate that tumor PE is more difficult to diagnose clinically and may be misdiagnosed as thrombotic PE. Finally, these data suggest that in all cancer patients, the presence of both thrombotic and tumor PE should be considered because of similarities in their clinical features.

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^☆: Supported in part by Biomedical Research Support Grant No. 2-S07-RR05950.

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Clinical suspicion of autopsy-proven thrombotic and tumor pulmonary embolism in cancer patients☆

Abstract

Am J Med

Chest

The hypercoagulable states

Ann Intern Med

Causes of death in cancer patients

J Med

Nonthrombotic pulmonary embolism

Microscopic pulmonary tumor emboli associated with dyspnea

Cancer

Microscopic tumor emboli to the lungs: a hidden cause of dyspnoea and pulmonary hypertension

Thorax