ABSTRACT
We report a case of a 63-year-old woman who developed acute right heart failure and an achalasia-like syndrome with limited cutaneous systemic sclerosis (lcSSc) and primary biliary cirrhosis. Intravenous administration of diuretics improved her acute heart failure. Anti-centromere antibodies and anti-mitochondria antibodies were present. A coronary angiogram and a Swan-Ganz catheter revealed no abnormalities. Thallium-201 scan at rest demonstrated mild perfusion defects in both the apex and the anteroseptal and the inferior myocardium. A cine-esophagram revealed an achalasia-like syndrome. Though rare, physicians should be aware that some patients with lcSSc may develop acute right heart failure or achalasia-like syndrome.
Subject(s)
Esophageal Achalasia/diagnosis , Heart Failure/diagnosis , Liver Cirrhosis, Biliary/diagnosis , Scleroderma, Limited/diagnosis , Acute Disease , Electrocardiography , Esophageal Achalasia/complications , Esophageal Achalasia/physiopathology , Female , Heart Failure/complications , Heart Failure/physiopathology , Humans , Liver Cirrhosis, Biliary/complications , Liver Cirrhosis, Biliary/physiopathology , Middle Aged , Scleroderma, Limited/complications , Scleroderma, Limited/physiopathologyABSTRACT
We report a case of carcinomatous lymphangitis of the lungs due to and stomach cancer showing remarkable response to TS-1. The patient was a 51-year-old man whose chest x-ray and computed tomography (CT) revealed lymphangitis, and endoscopic examination showed stomach cancer on posterior wall of stomach body. Bone marrow metastasis was suspected because platelet count was 50/microliter, and myelocytes and metamyelocytes emerged in peripheral blood. TS-1 80 mg/day was administered orally for 28 days as 1 course. After 4 courses of TS-1, chest x-ray showed remarkable improvement, and platelet count was normalized. The patient survived for 10 months after the first visit. We suggest that TS-1 is an effective therapy for carcinomatous lymphangitis of the lungs due to stomach cancer.
