Case Report
Copyright ©The Author(s) 2019.
World J Gastroenterol. Dec 28, 2019; 25(48): 6949-6958
Published online Dec 28, 2019. doi: 10.3748/wjg.v25.i48.6949
Table 1 Laboratory examination
WBC4840/μLTP8.0 g/dLHBs Ag-
Neutro70.5 %Alb3.4 g/dLAnti-HBs-
Lymp16.9 %BUN14 mg/dLAnti-HBc-
Eos.3.7 %Cre0.59 mg/dLAnti-HCV-
Bas.0.4 %T-Bil1.0 mg/dL
Mon.8.5 %D-Bil0.2 mg/dLAFP67183 ng/mL
RBC392 × 104 /μLAST74 IU/LAFP-L337.2 %
Hb12.4 g/dLALT31 IU/LPIVKA-II> 75000 mAU/mL
Ht.35.9 %ALP828 IU/LKL-6300 IU/mL
Plt.8.0 × 104 /μLLDH432 IU/LSP-D87.6 ng/mL
γ-GTP737 IU/L
ChE165 IU/L
NH392 μL/dL
Na130 mEq/LBlood Gas Analysis of 6th day (O2 2L)
K3.8 mEq/LSpO291%
Cl100 mEq/LpH7.456
CoagulationP3.3 mg/dLpCO235.2 mmHg
PT%76 %Ca9.0 mg/dLpO262.9 mmHg
PT-INR1.15CRP5.37 mg/dLHCO324.3 mmol/L
APTT36.3 secFBS103 mg/dLBE0.7 mmol/L
HbA1c5.5 %
TG58 mg/dL
HDL-C50 mg/dL
LDL-C138 mg/dL
Table 2 Summary of the cases reported
CaseRef.Age (yr)GenderEtiologyChild-Pugh scoreBCLC stageSymptomRespiratory failureSIRS scoreInvasion to IVCDiagnosisTreatmentSteroidOutcomePrognosis (d)Image of lungPathology of lungPathology of liver
1Uruga et al[1]60FHCVBCDyspnea+2N/AAutopsyOxygen+Death4Mild elevation of CT numberModerately differentiated HCC in lung small blood vesselsN/A
2Nakamura et al[4]52MAlcoholBCFever, dry cough+3+Lung scintigraphyDecompression+Death330Multiple plaques on both lungsMultiple tumor embolism of both pulmonary arteriesUndifferentiated HCC
3Sato et al[5]58MN/ABCDyspnea+3N/AAutopsyOxygen-Death15No imagingMultiple pulmonary arterial tumor, thrombusN/A
4Shinzato et al[6]56MN/AN/ACDyspnea, consciousness disorder+2+AutopsyN/A-Death2Blurred nodular shadow, airbronchogramTumor embolism, hemorrhagic necrosisdifferentiated HCC
5Ohta et al[7]62MAlcohol + HCVBCChest pain+N/A+AutopsyN/A-Death60Enhancement of pulmonary arteryMultiple pulmonary artery tumor embolismMedium to well-differentiated HCC
6Koskinas et al[8]30FHBVN/ACShortness of breath+3N/AAutopsyOxygen-Death0No imagingInvasion of vein by the carcinomaN/A
7Jäkel et al[9]48MAlcoholN/ACAscitesN/AN/A+AutopsyN/A-Death16UnremarkableMultiple pulmonary artery tumor embolismN/A
8Yamauchi et al[10]58MHBVN/ACDyspnea+0+AutopsyOxygen-Death5Coin lesionTumor thrombi in both pulmonary arteriessarcomatoid HCC
9Tanaka et al[11]76MHCVBCDyspnea+N/AN/AAutopsyAntibiotic, FOY-Death13Many ground-glass patterns and partly consolidation in both lung field multiple defect (lung scintigraphy)Venous thrombi of the poorly differentiated hepatocellular carcinomapoorly HCC
10Nepal et al[12]59MAlcohol + HCVBCAbdominal fullness01+N/AN/AN/AN/AN/AUnremarkableN/AN/A
11Chan et al[13]52MHBVN/ACMalaise, loss of appetite0N/A+AutopsyN/AN/AN/AN/ANo imagingMassive necrotic tumor emboli in both pulmonary trunks.Moderately differentiated
12Diaz Castro et al[14]71MHCVN/ACChest pain+N/A+AutopsyUrokinase-Death4 dNo imagingTumor thrombi in pulmonary arteriesN/A
13Gutiérrez-Macías et al[15]41MAlcoholN/ACDyspnea, chest pain, sweating+3N/AAutopsyAntibiotic, antithrombotic therapy+Death2Filling defect in the left pulmonary arterySmall blood vessels occluded by clusters of malignant cellsN/A
14Wilson et al[16]65MN/AN/ACDyspnea+N/A+Embolic materialAntithrombotic therapy, embolic material recovery-SurviveN/ANo imagingN/AN/A
15Mularek-Kubzdela et al[17]49MHBVN/ACShortness of breath, lower extremity edema+N/A+CT,lung scintigraphy, United StatesN/AN/AN/AN/ANo imagingN/AN/A
16Lin et al[18]57MHBVBCChest pain、dyspnea+N/A+Autopsy, echocardiographySurgery-Death40Multiple segmental perfusion defects (lung scintigraphy)N/AN/A
17Papp et al[19]63MHBV or HCVN/ACFever-N/A+Autopsy, echocardiographySurgery-DeathN/ANo imagingTumor embolism, right atrium tumor embolismsmall round cell HCC
18Clark et al[20]65MHCVN/ACDyspnea, abdominal pain, malaise+N/A+AutopsyComfort care-Death4No imagingThe large right atrial tumor thrombus and multiple pulmonary emboliN/A
Our caseN/A72MAlcoholACDyspnea+2N/AAutopsyOxygen+Death37Glass shadow of bilateral lungsMicropulmonary artery tumor embolism in both lungModerate to poorly differentiated HCC