Unusual hemodynamic findings in a patient with obstruction of the pulmonary vein by tumor
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A 63-year-old woman with chronic obstructive airway disease presented with progressive dyspnea, episodic chest pain, a left lower lobe infiltrate and a pleural transudate. Right-heart catheterization showed pulmonary arterial diastolic and capillary wedge pressures elevated on the left side. At autopsy, she had an anaplastic carcinoma encasing and invaginating the left pulmonary vein. The pleural transudate probably resulted from a combination of unilateral pulmonary venous hypertension, and local changes in the systemic pleural capillaries and subpleural lymphatics. Invasion of pulmonary veins by tumor is observed frequently at autopsy, but is infrequently diagnosed during life.
Key wordsLung cancer Pulmonary venous obstruction Pleural effusion
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