Platelet-derived growth factor receptor-tyrosine kinase inhibitor, imatinib, is effective for treating pulmonary hypertension induced by pulmonary tumor thrombotic microangiopathy

International Heart Journal
Shun MinatsukiIssei Komuro

Abstract

Pulmonary hypertension (PH) induced by pulmonary tumor thrombotic microangiopathy (PTTM) can be fatal because its rapid progression confounds diagnosis, and it is difficult to control with therapy. Here we describe a woman with symptomatic PTTM-PH accompanying gastric cancer that was suspected from perfusion scintigraphy. PTTM-PH was diagnosed by gastroesophageal endoscopy and lung biopsy after partial control of PH using the platelet-derived growth factor (PDGF) receptor (PDGFR) tyrosine kinase inhibitor, imatinib. Treatment with sildenafil and ambrisentan further decreased PH, and she underwent total gastrectomy followed by adjuvant TS-1 chemotherapy. PH did not recur before her death from metastasis. Postmortem histopathology showed recanalized pulmonary arteries where the embolized cancer masses disappeared. PDGF-A, -B, and PDGFR-α, β expression was detected in cancer cells and proliferating pulmonary vascular endothelial cells. Thus, PTTM-PH was successfully controlled using a combination of imatinib, drugs to treat pulmonary arterial hypertension, and cancer management.

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Citations

Jul 9, 2016·Current Opinion in Pulmonary Medicine·Laura C PriceStephen J Wort
Dec 24, 2017·Journal of Medical Case Reports·Shinichi MiyazakiYoshinori Hasegawa
Feb 2, 2016·The European Respiratory Journal·Mansouria MeradUNKNOWN GrrrOH: Groupe de Recherche en Réanimation Respiratoire en Onco-Hématologie (Group for Research in Respiratory Intensive Car
Feb 8, 2019·European Respiratory Review : an Official Journal of the European Respiratory Society·Laura C PriceS John Wort
Feb 6, 2020·The New England Journal of Medicine·Kristin D'SilvaJoseph Loscalzo
Apr 30, 2019·Pulmonary Circulation·Rohit H GodboleNader Kamangar
Mar 29, 2020·The Journal of International Medical Research·Ning CuiJingming Zhao
Mar 17, 2020·International Heart Journal·Hiroshi OnodaKoichiro Kinugawa
Sep 1, 2021·Monaldi Archives for Chest Disease = Archivio Monaldi Per Le Malattie Del Torace·Federico RaimondiFabiano Di Marco

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