|
|
|
|
[2019] 5. Sohyung Park, Joo-Young Na, Byung-Ha Choi |
|
|
|
Poster :
Date : 19-12-02 11:03
Hit : 664
|
|
Publication; issue : 2019 Year 43 Vol 4 iss 153 p
|
(942.1K), Down : 50, 2019-12-02 11:03:04 | |
Sudden Unexpected Death During Bronchoscopy
of a Patient with Pulmonary Lymphangitic Carcinomatosis and Pulmonary Tumor
Thrombotic Microangiopathy due to Gastric Cancer
Korean J Leg Med 2019;43:153-158
|
|
Medical Examiner’s Office, National
Forensic Service, Wonju, Korea,
Department of Pathology, Pusan National
University Yangsan Hospital, Yangsan, Korea,
Division of Forensic Investigation,
National Forensic Service Seoul Institute, Seoul, Korea
E-mail: zzeva@korea.kr
We present the case of a 48-year-old woman
who complained of sustained dyspnea and newly developed dyspnea, who then
suddenly and unexpectedly expired during bronchoscopy. On postmortem
examination, the deceased had advanced gastric cancer as a primary tumor.
Frequent lymphatic tumor emboli were observed with some pulmonary lymphangitic
carcinomatosis (PLC), and pulmonary tumor thrombotic microangiopathy (PTMA).
PLC and PTMA are lethal forms of pulmonary metastasis, and PTMA can lead to
sudden death. The characteristic findings of PLC and PTMA in the deceased were
not predominant, however, and the clinical manifestation was not acutely
deteriorating. These findings are, therefore, insufficient to explain the
deceased’s sudden death. Clinically, the deceased manifested hypoxemia,
bradycardia and cardiac arrest during bronchoscopy and then soon expired,
suggesting the possibility of cardiovascular complication related to
bronchoscopy. Despite several limitations, we assumed that the sudden
unexpected death might have been induced by cardiovascular complications
related to bronchoscopy and due to the underlying pathologic condition by PLC
and PTMA.
Key Words: Forensic pathology; Autopsy;
Postmortem; Lymphatic carcinomatosis; Stomach neoplasms; Pulmonary tumor thrombotic
microangiopathy
|
|
|
|
|
|
|
|
|
|
Tel. 82+ 02-6954-1976 / Fax. 82+ 070-8220-8881 |
27-9, Gukjegeumyung-ro 8-gil, Yeongdeungpo-gu, Seoul, Republic of Korea |
COPYRIGHT© All RIGHTS RESERVED. |