PULMONARY TUMOR MICROEMBOLISM

Pulmonary tumor embolism is an often missed antemortem diagnosis in pa tients with cancer and respiratory failure. Although rare, this compli cation is an important cause of additional morbidity. Referred for rad ionuclide pulmonary perfusion and ventilation scintigraphy, a typical pattern of multiple subsegmental peripheral defects on perfusion lung scanning without matching ventilation defects, suggesting a high proba bility for pulmonary thromboembolism, often leads to false conclusions . We present a case of bilateral multiple subsegmental mismatched defe cts in lung ventilation perfusion scintigraphy, where autopsy confirme d the diagnosis of pulmonary tumor embolism, secondary to an undiffere ntiated ductal type adenocarcinoma of the pancreas. Pulmonary tumor em bolism is an entity to keep in mind in patients treated for carcinoma presenting with (sub) acute dyspnea.