NPPB and neoplasm: The patient was suspected of having PTTM with a pancreatic primary malignancy, based on admission findings including percutaneous oxygen saturation of 88%, respiratory alkalosis on blood-gas analysis, and elevated levels of d-dimer, NT-proBNP, and multiple tumor markers, combined with computed tomography angiography results showing enlarged lymph nodes (mediastinum, bilateral hila, right cardiophrenic angle, retroperitoneum) and a blurred peripancreatic space.