PDF(Pubmed)
Abstract：
Lung cancer can lead to hypercoagulability that causes thromboembolic events such as pulmonary emboli, deep vein thrombosis, ischemic strokes, and non-bacterial thrombotic endocarditis. While it is not uncommon for cancer to cause thromboembolic events, it is unusual for thrombotic events to be the first manifestation of cancer. In the following report, we review the case of a 59-year-old woman who presented with melena and abdominal pain. She had a pertinent history of multiple thromboembolisms while on anticoagulation four months before this presentation. Upon admission, it was discovered that the patient had new pulmonary emboli, and further workup revealed that her gastrointestinal symptoms were due to ischemic colitis. While initial imaging showed no evident masses that would heighten suspicion of cancer, she had persistent abdominal lymphadenopathy. Therefore, she also underwent an abdominal lymph node biopsy which revealed metastatic lung adenocarcinoma, a possible cause of her hypercoagulable state. This case report highlights the importance of considering malignancy in the differential of a patient with recurrent thromboembolism and raises the question of whether standardized screening for malignancy in patients with multiple thromboembolic events would be beneficial.
摘要：
肺癌可导致高凝，导致血栓栓塞事件，如肺栓塞，深静脉血栓形成,缺血性中风,和非细菌性血栓性心内膜炎。虽然癌症引起血栓栓塞事件并不少见，血栓形成事件是癌症的第一表现是不寻常的。在以下报告中，我们回顾了一例59岁女性出现黑便和腹痛的病例。她在接受抗凝治疗前四个月有多次血栓栓塞的相关病史。一被录取,发现病人有新的肺栓塞，进一步的检查显示，她的胃肠道症状是由于缺血性结肠炎。虽然最初的成像显示没有明显的肿块会增加对癌症的怀疑，她有持续性的腹部淋巴结肿大。因此,她还接受了腹部淋巴结活检，发现转移性肺腺癌，可能是她血液高凝状态的原因.该病例报告强调了在复发性血栓栓塞患者的鉴别中考虑恶性肿瘤的重要性，并提出了一个问题，即对患有多种血栓栓塞事件的患者进行标准化的恶性肿瘤筛查是否有益。
