• Clinical and Experimental Pediatrics
• /
• v.55 no.7
• /
• pp.249-253
• /
• 2012

We report a case of a 13-year-old girl with acute lymphoblastic lymphoma- leukemia, who presented with a cardiac metastasis in the right ventricle, resulting in a pulmonary embolism. At the time of her leukemia diagnosis, a cardiac mass was incidentally found. The differential diagnosis for this unusual cardiac mass included cardiac tumor, metastasis, vegetation, and thrombus. Empirical treatment was initiated, including anticoagulation and antibiotics. She underwent plasmapheresis and was administered oral prednisolone for her leukemia. Five days later, she experienced sudden hemodynamic collapse and required extracorporeal membrane oxygenation insertion and emergency surgery. These interventions proved futile, and the patient died. Pathology revealed that the cardiac mass comprised an aggregation of small, round, necrotic cells consistent with leukemia. This is the first known case of acute lymphoblastic leukemia presenting as a right ventricular mass, with consequent fatal acute pulmonary embolism. A cardiac mass in a child with acute leukemia merits investigation to rule out every possible etiology, including vegetation, thrombus, and even a mass of leukemic cells, which could result in the fatal complication of pulmonary embolism.

• Tuberculosis and Respiratory Diseases
• /
• v.45 no.3
• /
• pp.654-660
• /
• 1998

Pulmonary embolism is one of the moot common acute pulmonary disease in the adult general hospital population However, the disease is still frequently unsuspected and underdiagnosed due to the nonspecificity of both clinical findings and laboratory tests. The chest radiography in a patient suspected acute pulmonary embolism do not provide adequate information to establish or exclude the diagnosis of pulmonary embolism. Even in the case of infarction, there is no pathognomonic clues on the chest film. Rarely infarction presents unusual roentgenologic manifestation such as lobar consolidation, coin lesion, multinodular opacity, or massive pleural effusion Especially, lobar consolidation in pulmonary embolism might mislead into the diagnosis of pneumonia. We experienced a case of pulmonary embolism presenting lobar consolidation in a 62 years old woman, originated from deep vein thrombosis. She took a compression stocking and underwent anticoagulant therapy with excellent outcome.

• Journal of Chest Surgery
• /
• v.43 no.4
• /
• pp.433-436
• /
• 2010

Acute massive pulmonary artery embolism after pulmonary resection is very rare, but has a high mortality rate. This is one of the most severe complications after pulmonary resection. Acute pulmonary artery embolism developed suddenly in a patient who underwent lobectomy and was recovering without complications. Because the patient’s condition was aggravated after conservative treatment, we did emergency open embolectomy which was successful. Hence, we report this case with a literature review.

• Tuberculosis and Respiratory Diseases
• /
• v.72 no.2
• /
• pp.232-235
• /
• 2012

Acute pulmonary embolism (PE) ranges from asymptomatic to often fatal, incidentally discovered emboli to massive embolism causing immediate death. Acute PE may occur rapidly and unpredictably and may be difficult to diagnose. Mortality and complications can be reduced by prompt diagnosis and therapy. Untreated PE is associated with a mortality rate of approximately 30 percents. Most patients with PE have endogenous fibrinolysis, although it is not effective enough to prevent PE. A case of spontaneous remission of untreated acute PE has not previously been reported. Here we present a case of spontaneously resolved acute PE without any treatment.

• Annals of Clinical Neurophysiology
• /
• v.25 no.1
• /
• pp.38-40
• /
• 2023

Acute pulmonary embolism (PE) is a life-threatening disease that manifests with cardiorespiratory symptoms. Syncope can be a rare, but warning sign of PE. We report a case of a 49-year-old male diagnosed with PE who presented with recurrent syncope prior to typical cardiorespiratory symptoms. His computed tomography pulmonary angiogram revealed bilateral PE. Syncope can be a rare clinical symptom of PE, but considering lethality of the disease, a differential diagnosis of PE should be considered in patients with recurrent syncope.

• Journal of Korean Neurosurgical Society
• /
• v.39 no.1
• /
• pp.72-74
• /
• 2006

We report a case of fatal aortic tumor embolism presenting as acute paraplegia. A four-year-old girl was referred from a local hospital with sudden paraplegia and a poor medical condition. A neighbor had noticed her fall from a bike, and she could not walk. She had no previous illness. Emergency spine MRI revealed no remarkable findings. During the process of evaluation, her general condition deteriorated progressively. Chest and abdominal CT showed a large mass in the left lung field, and a diagnosis of aortic occlusion was made. An emergency transfemoral embolectomy was attempted. However, the patency of the aorta was not recovered. On pathological examination of tissues taken from the embolectomy, a pleuro-pulmonary blastoma was found. The patient died 22 hours after the onset of her symptoms. We describe a possible mechanism for the tumor embolism. To the best of our knowledge, this is the first case report of aortic occlusion caused by an embolic malignancy, presenting as acute paraplegia.

• Tuberculosis and Respiratory Diseases
• /
• v.82 no.1
• /
• pp.53-61
• /
• 2019

Background: Antiphospholipid antibody syndrome (APS), an important cause of acquired thrombophilia, is diagnosed when vascular thrombosis or pregnancy morbidity occurs with persistently positive antiphospholipid antibodies (aPL). APS is a risk factor for unprovoked recurrence of pulmonary embolism (PE). Performing laboratory testing for aPL after a first unprovoked acute PE is controversial. We investigated if a specific phenotype existed in patients with unprovoked with acute PE, suggesting the need to evaluate them for APS. Methods: We retrospectively reviewed patients with PE and APS (n=24) and those with unprovoked PE with aPL negative (n=44), evaluated 2006-2016 at the Asan Medical Center. We compared patient demographics, clinical manifestations, laboratory findings, and radiological findings between the groups. Results: On multivariate logistic regression analysis, two models of independent risk factors for APS-PE were suggested. Model I included hemoptysis (odds ratio [OR], 12.897; 95% confidence interval [CI], 1.025-162.343), low PE severity index (OR, 0.948; 95% CI, 0.917-0.979), and activated partial thromboplastin time (aPTT; OR, 1.166; 95% CI, 1.040-1.307). Model II included age (OR, 0.930; 95% CI, 0.893-0.969) and aPTT (OR, 1.104; 95% CI, 1.000-1.217). Conclusion: We conclude that patients with first unprovoked PE with hemoptysis and are age <40; have a low pulmonary embolism severity index, especially in risk class I-II; and/or prolonged aPTT (above 75th percentile of the reference interval), should be suspected of having APS, and undergo laboratory testing for aPL.

• Journal of Yeungnam Medical Science
• /
• v.31 no.1
• /
• pp.52-55
• /
• 2014

Protein S deficiency is one of the several risk factors for thrombophilia and can cause blood clotting disorders such as deep vein thrombosis and pulmonary embolism. A 54-year-old man was admitted with the complaint of dyspnea and was diagnosed with pulmonary embolism. The patient had very low level of free protein S, total protein S antigen, and protein S activity (type I protein S deficiency). In history taking, we found that his mother, 78 year old, had a history of same disease 10 years ago, and confirmed the pronounced low level of protein S. The patient's son also had very low level of protein S, however there had not been any history of pulmonary embolism yet. This case study suggests that asymptomatic persons with a family history of protein S deficiency and pulmonary embolism should be checked regularly for early detection of the disease, as protein S deficiency can be suspected.

• Journal of Yeungnam Medical Science
• /
• v.21 no.2
• /
• pp.215-223
• /
• 2004

Silicone is widely used for medical purposes in breast augmentation and other cosmetic procedures. Illegal injections of silicone in human beings might have adverse effects and one of the serious problems is a silicone embolism. We experienced five cases of unusual respiratory difficulties after an injection of liquid silicone in the breast, vagina, uterus, and hip. They were all young adult females, who were previously healthy. One of them died after the injection. The three remaining patients were admitted because of dyspnea, coughing, chest discomfort and bilateral pulmonary infiltration after the silicone injection. A transbronchial lung biopsy and autopsy disclosed many oil like materials filling the alveolar septal capillaries. Three patients underwent a computed tomogram (CT), which revealed multifocal airspace consolidations at the peripheral and nondependent portions of both lungs, which is a different finding from other thromboembolisms. Lung scans of the disclosed abnormalities were compatible with silicone induced pulmonary embolism.

• The Korean Journal of Nuclear Medicine
• /
• v.19 no.2
• /
• pp.87-89
• /
• 1985

Unresolved major pulmonary embolism (UMPE) is an uncommon condition which causes pulmonary hypertension, cor pulmonale and death. An accurate and prompt diagnosis of UMPE is very important in the management of such patients with pulmonary embolectomy. Follow-up lung scans can lead to earlier diagnosis of UMPE especially on patients who have a history of acute pulmonary embolism in the past and. present with pulmonary hypertension, respiratory insufficiency and cor pulmonale. We report a case of UMPE strongly suggested by follow-up lung scans and subsequently confirmed by pulmonary angiography and postmortem examination.