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January 1967

Carcinomatosis of the Lung With Pulmonary Hypertension: Pathoradiologic Spectrum

Author Affiliations


From the departments of radiology (Dr. Altemus) and pathology (Dr. Lee), Presbyterian-University Hospital, University of Pittsburgh, Pittsburgh.

Arch Intern Med. 1967;119(1):32-38. doi:10.1001/archinte.1967.00290190080005

PULMONARY hypertension is a rare complication of lung carcinomatosis. Bristowe described the first case in 1868.1 Until 1961, only 17 cases appeared in the literature.2 Primarily, the discussions pertained to the unique clinical and pathological aspects, with little, if any, attention focused upon the associated roentgenographic findings.

Since the onset of symptoms and clinical course differed from either acute or chronic cor pulmonale, the term "subacute" cor pulmonale was advocated by Brill and Robertson in 1937.3 This terminology was used specifically for malignant tumor embolization of the lung. However, subsequent reports emphasized that nonmalignant emboli originating from veins or uterine trophoblastic elements may initiate the identical clinical picture.4-6 Furthermore, pure lymphangitic carcinomatosis may provoke sufficient changes within the pulmonary vascular bed to induce pulmonary hypertension and, in turn, the same characteristic clinical picture.7-9

A review of the literature and three cases encountered at Presbyterian-University Hospital disclosed a radiologie spectrum which

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