{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T05:56:39Z","timestamp":1790834199873,"version":"4.1.0"},"reference-count":6,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T00:00:00Z","timestamp":1790726400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T00:00:00Z","timestamp":1790726400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Respirology Case Reports"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Pulmonary tumour thrombotic microangiopathy (PTTM) is a rare but frequently fatal condition characterized by rapidly progressive pulmonary hypertension and right heart failure caused by tumour microemboli in the pulmonary vasculature. We report the case of a 64\u2010year\u2010old man who presented with rapidly progressive respiratory failure. Chest computed tomography demonstrated centrilobular nodules and a tree\u2010in\u2010bud (TIB) pattern. Pulmonary perfusion scintigraphy and transthoracic echocardiography suggested pulmonary hypertension with multiple peripheral perfusion defects, raising strong clinical suspicion for PTTM. Transbronchial lung biopsy (TBLB) revealed TTF\u20101\u2013positive adenocarcinoma, although the primary tumour site remained undetermined. Based on these findings, clinically suspected PTTM was diagnosed and nivolumab monotherapy was promptly initiated as systemic treatment for the underlying malignancy. Despite transient severe deterioration, the patient's respiratory function improved markedly, and he has remained progression\u2010free for more than 3\u2009years. This case highlights the importance of early clinical recognition of PTTM and prompt initiation of appropriate systemic therapy, even before definitive identification of the primary tumour when clinically warranted.<\/jats:p>","DOI":"10.1002\/rcr2.70763","type":"journal-article","created":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T04:55:06Z","timestamp":1790830506000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Long\u2010Term Survival Following Nivolumab Treatment in Pulmonary Tumour Thrombotic Microangiopathy Associated With Cancer of Unknown Primary: A Case Report"],"prefix":"10.1002","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-8991-4221","authenticated-orcid":false,"given":"Kosuke","family":"Fujishima","sequence":"first","affiliation":[{"name":"Department of Thoracic Surgery General South Tohoku Hospital  Koriyama Fukushima Japan"},{"name":"Department of Thoracic Surgery, Aizu Medical Center Fukushima Medical University  Aizuwakamatsu Fukushima Japan"},{"name":"Department of Chest Surgery Fukushima Medical University  Fukushima Fukushima Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Osugi","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery General South Tohoku Hospital  Koriyama Fukushima Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoshi","family":"Noma","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine General South Tohoku Hospital  Koriyama Fukushima Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitsunori","family":"Higuchi","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Aizu Medical Center Fukushima Medical University  Aizuwakamatsu Fukushima Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4457-1863","authenticated-orcid":false,"given":"Hiroyuki","family":"Suzuki","sequence":"additional","affiliation":[{"name":"Department of Chest Surgery Fukushima Medical University  Fukushima Fukushima Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,30]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/2045894019851000"},{"key":"e_1_2_10_3_1","first-page":"243","article-title":"A Case of Stage IV Breast Cancer With Long\u2010Term Survival by Chemotherapy Developing Pulmonary Tumor Thrombotic Microangiopathy During the Treatment Course","volume":"44","author":"Kobayashi K.","year":"2017","journal-title":"Gan to Kagaku Ryoho"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/pul2.12047"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.176.6.1761421"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.3892\/mco.2024.2752"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/pul2.12359"}],"container-title":["Respirology Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/rcr2.70763","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/rcr2.70763","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/rcr2.70763","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T04:55:08Z","timestamp":1790830508000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/rcr2.70763"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,30]]},"references-count":6,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["10.1002\/rcr2.70763"],"URL":"https:\/\/doi.org\/10.1002\/rcr2.70763","archive":["Portico"],"relation":{},"ISSN":["2051-3380","2051-3380"],"issn-type":[{"value":"2051-3380","type":"print"},{"value":"2051-3380","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,30]]},"assertion":[{"value":"2026-06-08","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-08","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-30","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70763"}}