Tuberc Respir Dis.  2012 Jan;72(1):63-67.

Microvascular Pulmonary Tumor Embolism Detected by Perfusion Images of Dual-Energy Computed Tomography

Affiliations
  • 1Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
  • 2Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. ymoh55@amc.seoul.kr
  • 3Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

Abstract

Although advances in multi-detector computed tomography (CT) technique make it possible to evaluate peripheral subsegmental pulmonary arteries, several studies have reported that small peripheral embolisms may still be missed. Recently, some reports demonstrated that dual-energy CT improved the capability to detect peripheral pulmonary embolism. We report a case of lymphoma presenting as disseminated microvascular pulmonary tumor embolism, detected by perfusion images using dual energy CT.

Keyword

Neoplasm; Pulmonary embolism; Tomography, X-Ray Computed

MeSH Terms

Embolism
Lymphoma
Neoplastic Cells, Circulating
Perfusion
Pulmonary Artery
Pulmonary Embolism
Tomography, X-Ray Computed

Figure

  • Figure 1 Chest X-ray on admission revelaed no remarkable lesion despite hypoxemia.

  • Figure 2 No tumor or thromboemboli was observed on the initial pulmonary computed tomographic angiography.

  • Figure 3 Multiple ventilation/perfusion mismatching lesions were seen in both lung fields.

  • Figure 4 Dual energy computed tomography showed a perfusion defect (marked with asterisk) in both sides of the lung field (left). The PET scan revealed a high FDG uptake in similar sites (right). PET: positron emission tomography.

  • Figure 5 18-FDG PET indicated a hypermetabolic lesion in the bone marrow.


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