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Haemoptysis in pregnancy caused by a well-differentiated fetal adenocarcinoma: a case report.

Thompson RJ, Hasleton PS, Taylor PM, Woodhead M, Byrd LM - J Med Case Rep (2010)

Bottom Line: However, it can also be an indicator of serious pathology.We report the case of a 27-year-old Caucasian woman who presented with haemoptysis in pregnancy that was discovered to be caused by a well-differentiated fetal adenocarcinoma of the lung.This case demonstrates the importance of establishing an accurate diagnosis when a pregnant woman presents with haemoptysis and that more serious pathology should be considered if the clinical symptoms persist and/or the presumed diagnosis of pulmonary embolism is not confirmed.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Obstetrics and Gynaecology, St Mary's Hospital, Hathersage Road, Manchester M13 9WL, UK. becky_thompson@hotmail.co.uk.

ABSTRACT

Introduction: Haemoptysis in pregnancy is frequently assumed to be caused by a pulmonary embolism. However, it can also be an indicator of serious pathology.

Case presentation: We report the case of a 27-year-old Caucasian woman who presented with haemoptysis in pregnancy that was discovered to be caused by a well-differentiated fetal adenocarcinoma of the lung.

Conclusion: This case demonstrates the importance of establishing an accurate diagnosis when a pregnant woman presents with haemoptysis and that more serious pathology should be considered if the clinical symptoms persist and/or the presumed diagnosis of pulmonary embolism is not confirmed.

No MeSH data available.


Related in: MedlinePlus

Computed tomography pulmonary angiogram demonstrating cavitating mass in right lung.
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Figure 2: Computed tomography pulmonary angiogram demonstrating cavitating mass in right lung.

Mentions: When seen in the antenatal clinic at 28 weeks gestation, she reported further episodes of haemoptysis. She was therefore admitted immediately for investigation. The working diagnosis was pulmonary embolism and as such she was fully anticoagulated with low molecular weight heparin (LMWH). Arterial blood gases breathing air were within normal limits (pO2 92.5 mmHg, 12.3 kPa; pCO2 33.6 mmHg 4.47 kPa), and sputum cultured normal upper respiratory tract flora. A chest x-ray (Figure 1) demonstrated a small right basal pleural reaction and some right basal atelectasis, which may indicate pulmonary embolic disease. A perfusion lung (V/Q) scan gave an indeterminate risk of pulmonary embolus. Nevertheless, despite several days of adequate treatment with LMWH (post dose Factor Xa 0.6), she had continued haemoptysis and a respiratory opinion was therefore sought. As a pulmonary embolus had as yet not been confirmed and the condition of the patient appeared to be worsening despite adequate therapy, bilateral leg Doppler's and a computed tomography pulmonary angiogram (CTPA) were performed. The former showed no evidence of a deep vein thrombosis. The latter revealed no pulmonary embolus but rather a cavitating mass of 4 cm in diameter within the right lung, immediately posterior to the hilum and occluding the lower lobe bronchus (Figure 2).


Haemoptysis in pregnancy caused by a well-differentiated fetal adenocarcinoma: a case report.

Thompson RJ, Hasleton PS, Taylor PM, Woodhead M, Byrd LM - J Med Case Rep (2010)

Computed tomography pulmonary angiogram demonstrating cavitating mass in right lung.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2823759&req=5

Figure 2: Computed tomography pulmonary angiogram demonstrating cavitating mass in right lung.
Mentions: When seen in the antenatal clinic at 28 weeks gestation, she reported further episodes of haemoptysis. She was therefore admitted immediately for investigation. The working diagnosis was pulmonary embolism and as such she was fully anticoagulated with low molecular weight heparin (LMWH). Arterial blood gases breathing air were within normal limits (pO2 92.5 mmHg, 12.3 kPa; pCO2 33.6 mmHg 4.47 kPa), and sputum cultured normal upper respiratory tract flora. A chest x-ray (Figure 1) demonstrated a small right basal pleural reaction and some right basal atelectasis, which may indicate pulmonary embolic disease. A perfusion lung (V/Q) scan gave an indeterminate risk of pulmonary embolus. Nevertheless, despite several days of adequate treatment with LMWH (post dose Factor Xa 0.6), she had continued haemoptysis and a respiratory opinion was therefore sought. As a pulmonary embolus had as yet not been confirmed and the condition of the patient appeared to be worsening despite adequate therapy, bilateral leg Doppler's and a computed tomography pulmonary angiogram (CTPA) were performed. The former showed no evidence of a deep vein thrombosis. The latter revealed no pulmonary embolus but rather a cavitating mass of 4 cm in diameter within the right lung, immediately posterior to the hilum and occluding the lower lobe bronchus (Figure 2).

Bottom Line: However, it can also be an indicator of serious pathology.We report the case of a 27-year-old Caucasian woman who presented with haemoptysis in pregnancy that was discovered to be caused by a well-differentiated fetal adenocarcinoma of the lung.This case demonstrates the importance of establishing an accurate diagnosis when a pregnant woman presents with haemoptysis and that more serious pathology should be considered if the clinical symptoms persist and/or the presumed diagnosis of pulmonary embolism is not confirmed.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Obstetrics and Gynaecology, St Mary's Hospital, Hathersage Road, Manchester M13 9WL, UK. becky_thompson@hotmail.co.uk.

ABSTRACT

Introduction: Haemoptysis in pregnancy is frequently assumed to be caused by a pulmonary embolism. However, it can also be an indicator of serious pathology.

Case presentation: We report the case of a 27-year-old Caucasian woman who presented with haemoptysis in pregnancy that was discovered to be caused by a well-differentiated fetal adenocarcinoma of the lung.

Conclusion: This case demonstrates the importance of establishing an accurate diagnosis when a pregnant woman presents with haemoptysis and that more serious pathology should be considered if the clinical symptoms persist and/or the presumed diagnosis of pulmonary embolism is not confirmed.

No MeSH data available.


Related in: MedlinePlus