Carcinomatose Linfangítica Pulmonar de Carcinoma de Pulmão de Pequenas Células: Relato de Caso de Autópsia
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A carcinomatose linfangítica pulmonar é caracterizada pelo acometimento dos vasos linfáticos pulmonares por células tumorais. Este trabalho relata os achados de autópsia de uma mulher de 53 anos que apresentou sintomas constitucionais subagudos e presença de numerosos nódulos pelo corpo. A tomografia computadorizada de tórax revelou massa heterogênea no mediastino posterior envolvendo estruturas torácicas e achados pulmonares sugestivos de disseminação linfangítica. Antes que fosse possível realizar avaliação diagnóstica adicional, a paciente apresentou rápida deterioração clínica, que resultou em óbito. A autópsia revelou massa mediastinal posterior com acentuado envolvimento linfático pulmonar por células neoplásicas. A análise imuno-histoquímica demonstrou positividade para CAM5.6, CD56 e Ki67, compatível com tumor neuroendócrino de alto grau. Observou-se também comprometimento metastático de coração, adrenal, pâncreas, duodeno e medula óssea. O diagnóstico final da autópsia foi tromboembolismo pulmonar como causa imediata do óbito, no contexto de um carcinoma pulmonar de pequenas células altamente agressivo com disseminação linfangítica pulmonar.
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