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Query: UMLS:C0034065 (pulmonary embolism)
 14,979 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Although pulmonary trophoblastic embolism is now considered a physiologic phenomenon of normal pregnancy, this phenomenon has not been demonstrated in a living asymptomatic patient. Recently we encountered a 26-year-old woman suspected of pulmonary embolism of villotrophoblastic tissues after therapeutic abortion. Although her serum beta-hCG was low, a computed tomography scan showed multiple nodules in both lungs. Histological examination of a nodule in a lung-biopsy specimen showed granulation tissue surrounding a hemorrhagic mass within which were structures resembling degenerating chorionic villi. Immunohistochemical study on the patient's lung nodule, and a second endometrial-curettage specimen, six control endometrial and tubal specimens containing degenerating chorionic villi, and four endometrial specimens containing viable chorionic villi were performed. The patterns of immunostaining for cytokeratin, human chorionic gonadotropin, human placental lactogen, placental alkaline phosphatase, and inhibin-alpha of the chorionic villus-like structures in the lung nodule were almost identical to those in the degenerating chorionic villi, but different from those of viable villi. This is a unique case of embolism of chorionic villi and trophoblast to the lung in a living patient after therapeutic abortion.
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PMID:Placental villotrophoblastic pulmonary emboli after elective abortion: immunohistochemical diagnosis and comparison with ten control cases. 1281 1

A 69-year-old man presented with cough, shortness of breath, and fatigue. He was initially treated for allergies and then for pulmonary embolism. Radiologically, a tumor mass was found to occlude the right pulmonary artery and involve the pulmonary trunk. A right pneumonectomy was performed. Histologically, a cellular malignant spindle and epithelioid tumor with areas of necrosis and brisk mitotic activity was seen. In some areas, the tumor appeared to form vascular channels. Focal osteosarcomatous differentiation was present. Immunohistochemical studies were performed including vimentin, smooth muscle actin, desmin, CD31, CD34, S100, and pan-cytokeratin. The tumor cells were positive for CD31 and vimentin and negative for pan-cytokeratin, CD34, and S100. Two months after surgery, the patient was alive and well.
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PMID:Pulmonary artery angiosarcoma: a clinicopathologic and radiological correlation. 1608 54

Sarcomas involving the lung are a rare occurrence, often a result of metastatic disease from primary malignancies involving the skin, liver, breast or heart. Primary pulmonary artery sarcomas are rarer still, with limited cases reported world-wide and consequently data regarding treatment modalities are sparse and largely experimental. These tumors are often mistaken for a pulmonary embolism and seemingly supported by radiological findings. Patients will often present without symptom resolution despite therapeutic anticoagulation. The following case illustrates how a soft tissue sarcoma of the pulmonary artery can mimic a pulmonary embolism, thus, resulting in both a diagnostic and therapeutic dilemma. A positron emission tomography scan was an invaluable tool in this case, showing increased radiotracer uptake and placing neoplasm at the top of the differential diagnosis. This ultimately led to a biopsy that was vimentin positive, cytokeratin negative and CD117 negative, thus consistent with soft tissue sarcoma.
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PMID:Pulmonary artery sarcoma mimicking a pulmonary embolism. 1862 58