由于高凝状态,癌症患者有血栓并发症的风险。然而,在这些患者的许多亚组中,预防性抗凝治疗的益处尚不清楚.对于活动性癌症患者的急性血栓栓塞性疾病(VTE)的首次发作,抗凝治疗至少持续3至6个月。在这里,我们向一名31岁的女性展示了活跃的,复发性IIIa期经典霍奇金淋巴瘤(CHL)(结节性硬化症),以前治疗过的近端上肢深静脉血栓形成(DVT),就诊以评估呼吸急促,并最终诊断为右心房血栓继发的双侧肺栓塞(PE)。患者通过手术切除血栓成功治疗。有了这个病例报告,我们希望鼓励医生在患有活动性癌症和既往DVT的患者中使用预防性无限期抗凝药物,包括上肢DVT患者。
Patients with cancer are at risk for thrombotic complications due to a hypercoagulable state. However, the benefit of prophylactic anticoagulation is unclear in many subsets of these patients. For the first episode of acute thromboembolic disease (VTE) in patients with active cancer, anticoagulant therapy is administered for at least three to six months. Herein, we present a 31-year-old female with active, recurrent stage IIIa classical Hodgkin lymphoma (CHL) (nodular sclerosis), previously treated for proximal upper extremity deep vein thrombosis (DVT), presenting for evaluation of shortness of breath and eventually diagnosed with bilateral pulmonary embolism (PE) secondary to a right atrial thrombus. The patient was successfully treated with surgical resection of the thrombus. With this case report, we hope to encourage physicians to use prophylactic indefinite anticoagulation in patients with active cancer and previous DVT, including patients with upper extremity DVT.