急死後の剖検により顕微鏡的肺動脈腫瘍塞栓症が判明した1例

A Case of a Microscopic Pulmonary Tumoral Embolisms Diagnosed at Autopsy after Sudden Death

要旨

　49 歳の男性が突然死する1年前より体のだるさ，3カ月前に頸部腫脹，2週間前から微熱を主訴に医療機関を受診していたが，原因は貧血以外明らかにならなかった．来院当日に呼吸困難が増悪し，自宅で心肺機能停止となった．当科に搬入されるが蘇生術に反応しなかった．剖検により顕微鏡的肺動脈腫瘍塞栓症と肺性心を伴う進行大腸癌の存在が判明した．癌年齢に達した成人の不定愁訴には，本症の存在を考慮する必要がある．

Summary

　A forty-nine-year-old man, who had complained of dullness for a year, neck swelling for 3 months and low grade fever for 2 weeks, consulted three doctors, but he was only diagnosed to have anemia, died suddenly after acute respiratory failure. An autopsy revealed advanced colon cancer with microscopic pulmonary tumoral embolisms and cor pulmonale. Microscopic pulmonary tumoral embolisms should thus be considered in the differential diagnosis when a middle-aged patient presents with unspecified complaints, might be suffering from an occult cancer.