J Korean Soc Radiol.  2014 Jul;71(1):14-19. 10.3348/jksr.2014.71.1.14.

Pulmonary Thromboembolism in Patients with Malignancy

Affiliations
  • 1Department of Radiology, College of Medicine, Yeungnam University, Daegu, Korea. stallin64@naver.com

Abstract

PURPOSE
We evaluated the CT findings of pulmonary thromboembolism (PTE) in patients with malignancy and compared these findings with the control group who had PTE without malignancy.
MATERIALS AND METHODS
During the last 5 years, 490 patients had PTE on CT examination. We classified the patients into two groups based on the presence and absence of malignancy. Among the included participants, 155 patients had malignancy and 335 patients did not have malignancy. The clinical and laboratory findings were reviewed. We analysed the CT findings for the level of the involved vessel, pulmonary embolism (PE) index, and association with deep vein thrombosis (DVT) on the leg. Differences were reviewed retrospectively. The most common primary malignancy was in the lung.
RESULTS
In the group with malignancy (155), 50 patient (32.3%) presented symptoms for PTE. The level of involved vessels were the main (15, 9.7%), below lobar (91, 58.7%), and below segmental (49, 31.6%). The PE index was 18.1 +/- 14.75, and 27 patients (42.2%) had DVT. In the control group (335), 216 patients (64.5%) presented symptoms for PTE. The level of the involved vessels were the main (75, 22.4%), below lobar (163, 48.6%), and below segmental (97, 29%). The PE index was 23.55 +/- 18.025, and 98 patient (41.4%) had DVT. The comparisons of the findings showed significant differences (p = 0.01) except for DVT.
CONCLUSION
More periphery of the involved vessels and the lower PE index are the features of PTE in patients with malignancy compared to the control group. The patient group had high incidence of unsuspected PTE than the control group, so special attention must be paid to this group.


MeSH Terms

Humans
Incidence
Leg
Lung
Pulmonary Embolism*
Retrospective Studies
Venous Thrombosis

Figure

  • Fig. 1 A seventy five years old man with cholangiocarcinoma and multiple metastasis. He had no symptom related with pulmonary thromboembolism. The axial contrast CT images at the level of left atrium (A) and coronal reconstructed image (B) shows thrombus in both lower segmental arteries (arrows). Pulmonary embolism index is 5 and deep vein thrombosis was not present.


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