肿瘤瘤栓性肺栓塞的临床特点

肺栓塞是指在循环血液中出现的不溶于血的异常物质,随着血流运行至肺动脉及其分支,导致血管腔阻塞所引起的病理现象.以脱落的血栓栓子引起的栓塞最常见,癌细胞团、脂肪滴、气体和羊水等亦可引起栓塞,但较为少见.近年来,随着恶性肿瘤发病率逐年增加,肿瘤瘤栓性肺栓塞逐渐引起临床医师的重视.尽管与肺血栓栓塞相比,瘤栓性肺栓塞在临床较为少见,但由于其缺乏特异性临床表现,并且患者生前确诊率低,常常在死亡后进行尸检时发现肺动脉血管内的瘤细胞栓子才能确诊,因此常常导致右心衰竭甚至死亡等不良临床后果.此外,近年来临床观察发现,肿瘤瘤栓性肺栓塞可以作为恶性实体肿瘤的首发临床表现.因此,对肿瘤瘤栓性肺栓塞做出早期、明确的诊断,对恶性肿瘤患者具有重要临床意义.

Clinical Characteristics of Pulmonary Tumor Embolism

Pulmonary embolism is defined as embolism that is not soluble in blood to the pulmonary circulation. Pulmonary thrombo- embism is the most frequently encountered disease. Compared with ＂ordinary＂ thrombotic pulmonary embolism, nonthrombotic pulmonary embolism which including tumor cells, fat, gas and amniotic fluid is less common. As the incidence of malignant tumor is relatively high in recent decades, pulmonary tumor embolism （PTUE） comes into the picture of clinicians. Compared with pulmonary thromboembism, the proportion of PTUE is lower. PUTE is clinically indistinguishable from thromboembolism, making the correct diagnosis achieved ante mortem challenging. The diagnosis is made mostly when the tumor emboli were seen microscopically through autopsy. Right heart failure and death often occurred from cor pulmonale due to tumor embolisation. In a few cases, PTUE can be the initial manifestation of underlying malignancy. So, making a correct diagnosis at the early stage of the disease has beneficial effects to the patients with malignancy.