Tumor Emboli Presenting as Pulmonary Hypertension *

increased alveolar pressure in the fluid-filled lung. 1 0 However, in our patient, the shift was noted at a time when the lung was not filled with fluid. It appears likely that the perfusion shift we observed was a response to regional alveolar hypoxia, related to the postiavage decrement in ventilation. 1 3 ' 1 4 Sequential ventilation-perfusion scintiphotographic studies also were useful in documenting restoration of gas exchange prior to lavage of an additional area. The functional impairment in the patient described was initially modest, and the improvement noted could be ascribed to spontaneous improvement as well as to the lavages performed. However, the most important aspect of the lavage sequence described was the ease and safety with which such focal lavage was applied to this patient. This suggests its possible extension to other clinical situations in which lavage would be helpful, but in which a temporary decrease in the gas-exchange function of an entire lung would not be acceptable.