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PubMed1975

Pulmonary infarction complicating the use of Swan-Ganz catheters.

Since the introduction of Swan-Ganz (flow-directed balloon-tipped) catheters, in 1970, relatively few serious complications have been reported. This report summarizes three cases of pulmonary infarction secondary to indwelling Swan-Ganz catheters. Two were due to wedging of the catheter and one probably to embolization or extension of thrombus from the tip of the catheter. The radiologist should be aware of this complication, as he is in an excellent position to first make the diagnosis.

Adult↗
PubMed1995

Disseminated Nocardia transvalensis infection resembling pulmonary infarction in a liver transplant recipient.

Infections due to Nocardia transvalensis are extremely rare: only four disseminated infections with this pathogen have been reported, three of which ended fatally. This is the first report of a liver transplant recipient with Nocardia transvalensis infection. The patient had disseminated infection with pulmonary involvement, which presented as pulmonary infarction. Despite a ten-day delay in the administration of correct therapy, he responded rapidly to trimethoprim-sulfamethoxazole. The pitfalls of differentiating nocardial infection from pulmonary thromboembolism in solid organ transplant recipients and the diagnostic considerations unique to liver transplant recipients are discussed.

Bacteremia↗
PubMed2002

Pulmonary infarct cytologically mimicking adenocarcinoma of the lung.

We describe a patient who underwent a right lower lobectomy for a lung lesion with a preoperative diagnosis of adenocarcinoma made on sputum cytology. Pathologic assessment of the resected specimen revealed a pulmonary infarct with no evidence of malignancy. All thoracic surgeons should be aware of this diagnostic pitfall. A positive sputum specimen should not always be regarded as definitive evidence of malignancy. Instead a full assessment of all available information should be made if unnecessary surgery is to be avoided.

Adenocarcinoma↗
PubMed1981

Massive pulmonary infarction during total cardiopulmonary bypass in unanesthetized spontaneously breathing lambs.

We provided total cardiopulmonary support for 1-18 hours in unanesthetized tethered lambs by peripheral vascular cannulation, using a roller pump and the spiral membrane lung. Respirations were allowed to remain spontaneous and unaided. A Swan-Ganz catheter was placed for retrograde pulmonary artery blood flow sampling. Within a few minutes following induced ventricular fibrillation the PCO2 of sampled blood flowing retrograde through the lungs fell below 10 mm Hg, the PO2 rose to near 150 mm Hg, the pH rose to above 7.8, and the glucose level fell to less than 20 mg %. All of these values later gradually shifted, approaching mixed venous blood values within minutes. After 1-18 hrs of perfusion the animals went into shock and were sacrificed. At autopsy, the lungs of animals breathing room air were beefy and hemorrhagic. In lambs that were "breathing" CO2 enriched air the retrograde pulmonary artery blood pH and PCO2 was usually maintained close to the mixed venous blood values. The observed pulmonary changes were considerably less abnormal, and the microscopic abnormalities were at times nonexistent. We believe the integrity of pulmonary blood flow is vital to the survival of the lungs as a functioning organ. Cessation of total forward pulmonary blood flow (unlike partial cardiopulmonary bypass), combined with spontaneous pulmonary ventilation, rapidly leads to massive, pulmonary infarctions, shock, and death.

Alkalosis, Respiratory↗
PubMed1982

Bronchogenic carcinoma associated with pulmonary infarction.

Chest radiographs of patients with suspected bronchogenic carcinoma occasionally show two adjacent opacities in the same lobe, one located centrally, the other more peripherally. Case histories and chest radiographs of five patients with these findings are presented. In each case, the centrally located mass was shown to be a bronchogenic carcinoma, while the more peripherally located density proved to be a pulmonary infarct. It is thus important to perform a biopsy of the proximal lesion rather than the peripheral one. The location and size of the infarct with respect to the bronchogenic carcinoma, as well as the possible cause of the infarct, are reviewed.

Carcinoma, Bronchogenic↗
PubMed1995

[Congenital protein C deficiency with pulmonary infarction].

A 45-year-old man was admitted with left chest pain and hemoptysis. Chest CT on admission showed multiple areas of wedge-shaped consolidation in both lung fields. A perfusion lung scintigram showed bilateral deficits in both lungs, whereas a ventilation scintigram was normal. The serum concentration and the functional activity of protein C were 41% and 42%, respectively. The same results were obtained from studies of the patient's mother and two sons, which indicated that this was a case of congenital protein C deficiency with pulmonary infarction.

Humans↗
PubMed1999

[Recurrent pulmonary infarction associated with familial protein S deficiency type III].

A 38-year-old woman was admitted to our hospital because of recurrent chest pain and fever. Chest X-ray films and computed tomograms showed subpleural consolidation containing small cavity-like opacities. Open lung biopsy revealed non-infectious abscess and vessels with organizing thrombus. The patient was given a diagnosis of pulmonary infarction due to the existence of deep venous thrombosis. Coagulation studies demonstrated that she had decreased plasma protein S activity, whereas her free and total protein S antigen levels were normal. Because her mother and maternal uncle and aunt also demonstrated decreased protein S activity with normal plasma protein S antigen levels, the patient was considered to be affected by familial protein S deficiency type III.

Adult↗
PubMed2001

[Pulmonary infarction caused by the spontaneous migration of the vena caval tumor thrombus of right renal cell carcinoma: a case report].

A 70-year-old male with right renal mass incidentally found by annual check-up using ultrasound, was referred to Department of Urology, Jikei University Affiliated Kashiwa Hospital. He was diagnosed as having right renal cell carcinoma with vena caval tumor thrombus extending above the diaphragm (T3c) preoperatively. The day before the scheduled day of operation, right pulmonary infarction caused by spontaneous migration of vena caval tumor thrombus of right renal cell carcinoma developed. Although arterial blood gas findings were poor, he only had low grade chest pain without shock. Therefore, we successfully performed right radical nephrectomy and thrombectomy of right pulmonary artery the next day. He was discharged 42 days postoperatively, but, he died from acute heart failure 9 months after the operation.

Aged↗
PubMed2004

[A case of multiple pulmonary infarctions associated with Sjögren's syndrome and antipsychotic agent administration].

A 56-year-old woman presented with complaints of general malaise and left chest pain. Chest radiography and CT scanning revealed multiple nodules and infiltrations in both lung fields. Her symptoms diminished and the extent of some of the lung shadows decreased spontaneously. However, since new shadows appeared later in other parts of the lung, she was admitted to our hospital on September 3. A transbronchial lung biopsy was not adequate for diagnosing a particular disease. But thoracoscopic lung biopsy specimens revealed necrosis with localized pleural fibrosis, and so a diagnosis of pulmonary infarction was made. The patient did not have any underlying disease or coagulation abnormalities, but Sjögren's syndrome and an antipsychotic agent were suspected to be background factors.

Antipsychotic Agents↗
PubMed1977

[Pulmonary perfusion in embolism of pulmonar arteries without pulmonary infarction (author's transl)].

Six autopsy lungs with embolism of the pulmonary arteries but without infarction, were subjected to comparative angiographic and morphologic examination of bronchial arteries. In pulmonary embolism without hemorrhagic infarction the disconnected vascular bed of pulmonary arteries can be demonstrated distally of the obstructive thrombo-embolism and with a noncapillary contrast medium. The vascular bed appears in intrapulmonal, precapillary, bronchopulmonal anastoses. The results of the investigation explain an intravital sufficient subsidiary circulation in the pulmonary areas separated from the normal circulation of pulmonary arteries. An extended subsidiary development of bronchial arteries in reaction to previous chronic pulmonary disease would help, according to our findings in postmortem lung angiographies, to support the circulation after embolism of pulmonary arteries.

Angiography↗