Pulmonary fat embolism of neoplastic origin. Embolia pulmonar gordurosa de origem neoplásica. Flávia Pinto, 1 Miriam Menna Barreto, 1 Daniela Braz Parente. Feedback. All fields marked with a star (*) are obligatory. Details. Your feedback * . Your E-mail address. Article received: December 10, Article accepted: June 1, Descritores: Cirurgia plástica; Lipoaspiração; Embolia gordurosa;. Embolia pulmonar.
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We report the case of a year-old female patient who had hypertension and diabetes and had recently been diagnosed ekbolia a right renal mass. Abdominal CT and magnetic resonance imaging MRI showed that the renal mass, which measured approximately 7.
Histopathological examination of a CT-guided percutaneous biopsy sample revealed the presence of clear pulmonarr and oxyphilic cells that were probably malignant, with a moderately elevated proliferative index; a diagnosis of malignant primary renal neoplasm was therefore made.
Shortly thereafter, emboliaa patient presented to the emergency room with respiratory complaints. A CT scan of the chest revealed the presence of negative fat density in a branch of the left pulmonary artery Figure 1 B. A chest CT angiography was subsequently performed and confirmed the presence of pulmonary fat embolism Figures 1 C and 1D. Therefore, a diagnosis of pulmonary embolism secondary to renal cell carcinoma was emholia. It is important to emphasize that the diagnosis of pulmonary tumor embolism was based on CT and MRI findings.
Abdominal CT showed that the embolus had negative density values, which are characteristic of fat. Contrast-enhanced MRI of the thorax was also performed, showing a signal drop in the thrombus on the fat-saturated and out-of-phase T1-weighted images, thus confirming the presence of pulmonary fat embolism. The same was found for the renal tumor and its extensions to the ipsilateral renal vein and the inferior vena cava.
An imaging finding of fat in a renal tumor is highly suggestive of angiomyolipoma. Fat is rarely associated with other renal neoplasms, such as renal cell carcinomas. Therefore, in addition to the known association between renal angiomyolipoma and fatty emboli in the pulmonary arteries, there is an association between renal cell carcinoma and fatty emboli, as demonstrated by the case reported herein. In conclusion, it is important to evaluate fat density thrombi in the pulmonary vessels of patients with renal neoplasms with or without respiratory symptoms for a diagnosis of pulmonary tumor embolism.
Embolia gordurosa by Michel Felipe on Prezi
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This is an open-access article distributed under the terms of the Creative Commons Attribution License. Open in a separate window. In A, coronal contrast-enhanced fat-saturated T1-weighted magnetic resonance image showing a renal tumor in the renal sinus arrowsinvading the right renal vein and extending into the inferior vena cava arrowheads. In B, axial CT scan without contrast enhancement, showing a filling defect with fat density in a branch of the left pulmonary artery arrow.
Axial and coronal CT angiography scans of the chest in C and D, respectively, showing a fatty embolus partially obstructing the pulmonary artery branch to the left lower lobe arrows. Renal cell carcinoma containing fat mimicking angiomyolipoma demonstration with CT scan and histopathology. A renal angiomyolipoma pulonar extension to the renal vein and asymptomatic fat pulmonary embolus. Ther Adv Respir Dis.
Yarmish G, DiPoce J. Case Aggressive angiomyolipoma with renal vein thrombosis and pulmonary fat embolus. Superior vena caval syndrome secondary to metastatic renal cell carcinoma.