Pulmonary tumor thrombotic microangiopathy of hepatocellular carcinoma: A case report and review of literature

Figure 1 Computed tomographic scans of hepatocellular carcinoma. A: Computed tomographic scans of hepatocellular carcinoma (HCC) in the liver; B: Computed tomographic scans of HCC in the metastases to sacral bone; C: Computed tomographic scans of HCC in the lung. White arrowheads indicate the tumor.

Figure 2 Clinical courses of physical and laboratory findings, chest radiograph, and computed tomographic scans. CT: Computed tomographic; BT: Body temperature; CRP: C-reactive protein; CTRX: Ceftriaxone sodium hydrate; MEPM: Meropenem; PSL: Prednisolone; SBT/ABPC: Sulbactam/ampicillin; SpO₂: Oxygen saturation; WBC: White blood cell count.

Figure 3 Histological analyses. A: Macroscopic findings of the lung; B: Hematoxylin and eosin staining of the tumor; C, D: Diffuse alveolar damages with multiple pulmonary artery tumor emboli. White arrows in cindicate the alveolar damage and arrowheads in Cindicate tumor cells. Black arrow in D indicates the recanalization and a white arrowhead indicates the fibrocellular intimal proliferation; E: Medial thickening of arterioles. A white arrowhead indicates the thickening; F: Tumor emboli (hematoxylin and eosin staining) were accompanied by the CD31-positive endothelial cell growth; G: CD31 staining, a white arrow head and fibrocellular intimal proliferation; H: Elastica van Gieson staining, a white arrow head.