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Tumoral pulmonary hypertension
Tumoral pulmonary hypertension (PH) comprises a variety of subtypes in patients with a current or previous malignancy. Tumoral PH principally includes the tumour-related pulmonary microvascular conditions pulmonary tumour microembolism and pulmonary tumour thrombotic microangiopathy. These inter-rel...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
European Respiratory Society
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9489033/ https://www.ncbi.nlm.nih.gov/pubmed/30728162 http://dx.doi.org/10.1183/16000617.0065-2018 |
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author | Price, Laura C. Seckl, Michael J. Dorfmüller, Peter Wort, S. John |
author_facet | Price, Laura C. Seckl, Michael J. Dorfmüller, Peter Wort, S. John |
author_sort | Price, Laura C. |
collection | PubMed |
description | Tumoral pulmonary hypertension (PH) comprises a variety of subtypes in patients with a current or previous malignancy. Tumoral PH principally includes the tumour-related pulmonary microvascular conditions pulmonary tumour microembolism and pulmonary tumour thrombotic microangiopathy. These inter-related conditions are frequently found in post mortem specimens but are notoriously difficult to diagnose ante mortem. The outlook for patients remains extremely poor although there is some emerging evidence that pulmonary vasodilators and anti-inflammatory approaches may improve survival. Tumoral PH also includes pulmonary macroembolism and tumours that involve the proximal pulmonary vasculature, such as angiosarcoma; both may mimic pulmonary embolism and chronic thromboembolic PH. Finally, tumoral PH may develop in response to treatments of an underlying malignancy. There is increasing interest in pulmonary arterial hypertension induced by tyrosine kinase inhibitors, such as dasatanib. In addition, radiotherapy and chemotherapeutic agents such as mitomycin-C can cause pulmonary veno-occlusive disease. Tumoral PH should be considered in any patient presenting with unexplained PH, especially if it is poorly responsive to standard approaches or there is a history of malignancy. This article will describe subtypes of tumoral PH, their pathophysiology, investigation and management options in turn. |
format | Online Article Text |
id | pubmed-9489033 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | European Respiratory Society |
record_format | MEDLINE/PubMed |
spelling | pubmed-94890332022-11-14 Tumoral pulmonary hypertension Price, Laura C. Seckl, Michael J. Dorfmüller, Peter Wort, S. John Eur Respir Rev Series Tumoral pulmonary hypertension (PH) comprises a variety of subtypes in patients with a current or previous malignancy. Tumoral PH principally includes the tumour-related pulmonary microvascular conditions pulmonary tumour microembolism and pulmonary tumour thrombotic microangiopathy. These inter-related conditions are frequently found in post mortem specimens but are notoriously difficult to diagnose ante mortem. The outlook for patients remains extremely poor although there is some emerging evidence that pulmonary vasodilators and anti-inflammatory approaches may improve survival. Tumoral PH also includes pulmonary macroembolism and tumours that involve the proximal pulmonary vasculature, such as angiosarcoma; both may mimic pulmonary embolism and chronic thromboembolic PH. Finally, tumoral PH may develop in response to treatments of an underlying malignancy. There is increasing interest in pulmonary arterial hypertension induced by tyrosine kinase inhibitors, such as dasatanib. In addition, radiotherapy and chemotherapeutic agents such as mitomycin-C can cause pulmonary veno-occlusive disease. Tumoral PH should be considered in any patient presenting with unexplained PH, especially if it is poorly responsive to standard approaches or there is a history of malignancy. This article will describe subtypes of tumoral PH, their pathophysiology, investigation and management options in turn. European Respiratory Society 2019-02-06 /pmc/articles/PMC9489033/ /pubmed/30728162 http://dx.doi.org/10.1183/16000617.0065-2018 Text en Copyright ©ERS 2019. https://creativecommons.org/licenses/by-nc/4.0/ERR articles are open access and distributed under the terms of the Creative Commons Attribution Non-Commercial Licence 4.0. |
spellingShingle | Series Price, Laura C. Seckl, Michael J. Dorfmüller, Peter Wort, S. John Tumoral pulmonary hypertension |
title | Tumoral pulmonary hypertension |
title_full | Tumoral pulmonary hypertension |
title_fullStr | Tumoral pulmonary hypertension |
title_full_unstemmed | Tumoral pulmonary hypertension |
title_short | Tumoral pulmonary hypertension |
title_sort | tumoral pulmonary hypertension |
topic | Series |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9489033/ https://www.ncbi.nlm.nih.gov/pubmed/30728162 http://dx.doi.org/10.1183/16000617.0065-2018 |
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