Gülru POLAT, Melih BÜYÜKŞİRİN, Zehra AŞUK, Gültekin TİBET

PULMONER TROMBOEMBOLİ İLE KOMPLİKE AKCİĞER KANSERİ OLGUSU

Malign hastalık ile tromboz arasındaki ilişki yıllardır bilinmektedir. Ancak kansere bağlı klinik olarak önemli trombotik komplikasyonun gerçek insidansı hala bilinmemektedir. Daha önce KHAK tanısı alarak 2 kür KT alan 59 yaşında erkek olgu sağ yan ağrısı ve halsizlik yakınmaları ile 3. kür açısından değerlendirilmek üzere başvurdu. Toraks BT'de; santral yerleşimli kitlenin küçüldüğü ancak sağ hemitoraksta plevral efüzyonla birlikte sağ ana pulmoner arterde trombus izlendi. Olgu pulmoner emboli ile komplike KHAK olarak değerlendirildi. Olguyu; pulmoner embolinin gelişebileceği düşünülmediği takdirde yanlış değerlendirmelere neden olabileceği ve tedavi kararını değiştirebileceğini göstermesi açısından sunmayı uygun gördük.

Anahtar Kelimeler:

Pulmoner emboli, akciğer kanseri

A CASE OF LUNG CANCER COMPLICATED WITH PULMONARY THROMBOEMBOLI

The association between malignancy and clinical thrombosis has been recognised for several years. However true incidence of clinically significant thrombotic complications due to cancer stil unknown. 59 years old male admitted to hospital with the complaints of pain on the right side and fatigue who had the diagnosis of small cell lung cancer and got 2 cyclus of chemotherapy applied for the 3rd cyclus. Computed tomography performed. Thrombus observed in the right pulmonary artery. We evaluated the case as small cell lung cancer complicated with pulmonary embolus. We presented the case, because occurence of pulmonary embolism made us to evaluate the disease as progressive erroneously according to chest radiography at first.

Keywords:

Pulmonary embolism, lung cancer,

PDF

___

1. Sutherland DE, Weitz IC, Liebman HA. Thromboembolic complications of cancer: epidemiology, pathogenesis, diagnosis, and treatment. Am J Hematol 2003; 72: 43-52.
2. Thompson CM, Rodgers RL. Analysis of autopsy records of 157 cases of carcinoma of the pancreas with particular reference to the incidence of thrombosis. Am J Med Sci 1952; 223: 469-76.
3. Sack GH, Levin J, Bell W. Trousseau’s syndrome and other manifestations of chronic disseminated coagulapathy in patients with neoplasm: clinical, pathophysiologic and therapeutic features. Medicine 1977; 56: 1-37.
4. Rickles FR, Levine MN, Dvorak HB. Abnormalities of hemostasis in malignancy. In: Colman RW, Hirsh J, Marder VJ, Clowes A, George JN, editors. Hemostasis and thrombosis. Philadelphia: Lippincott, Williams and Wilkins; 2001: 1132-52.
5. Rickles FR, Levine MN. Epidemiology of thrombosis in cancer. Acta Haematol 2001;106: 6-12.
6. Lieberman JS, Borrero J, Urdoncta E, Wright IS. Thrombophlebitis and cancer. J Am Med Assoc 1961; 177: 542-5.
7. Vertun-Baranowska B, Fijalkowska A, Tomkowski W, Filipecki S, Szymanska D. Pulmonary embolism in malignancy of the lung: a retrospective clinical evaluation and pathomorphologic personal material. Pneumonol Alergol Pol 1996; 64: 392-402.
8. Remiszewski P, Slodkowska J, Wiatr E, Szopinski J, Radomski P, Plodziszewska M, Rowinska-Zakrzewska E. Pulmonary thromboembolism as the main or secondary cause of death in patients treated for small cell lung cancer. Pneumonol Alergol Pol 1999; 67: 470-6.