Tuberc Respir Dis.  2014 Jul;77(1):34-37.

Multiple Hypercoagulability Disorders at Presentation of Non-Small-Cell Lung Cancer

• Lee JM
• Lim JH
• Kim JS
• Park JS
• Memon A
• Lee SK
• Nam HS
• Cho JH
• Kwak SM
• Lee HL
• Kim HJ
• Hong GJ
• Ryu JS

Abstract

Hypercoagulability disorders are commonly encountered in clinical situations in patients with a variety of cancers. However, several hypercoagulability disorders presenting as first symptoms or signs in cancer patients have rarely been reported. We herein described a case of a woman with adenocarcinoma of the lung presenting with deep vein thrombosis, nonbacterial thrombotic endocarditis, recurrent cerebral embolic infarction, and heart failure.

Keyword

Venous Thrombosis; Heart Failure; Thrombophilia; Endocarditis, Non-Infective; Carcinoma, Non-Small-Cell Lung

MeSH Terms

Adenocarcinoma
Carcinoma, Non-Small-Cell Lung
Endocarditis
Endocarditis, Non-Infective
Female
Heart Failure
Humans
Infarction
Lung
Lung Neoplasms*
Thrombophilia*
Venous Thrombosis

Figure

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  Figure 1 A 2×1.2-cm-sized nodular lesion in the left lingular division abutting to mediastinal pleura (A, arrow) and lymphadenopathies on the left paraaortic area, on chest CT scan at the time of diagnosis (B, arrow).

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  Figure 2 Computed tomogram angiogram for the legs showing venous thrombosis at the popliteal vein (A, arrow) and calf vein (B, arrow) of the right leg.

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  Figure 3 Brain magnetic resonance image showing a subacute stage infarction involving a territory of the right middle cerebral artery.

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  Figure 4 Vegetation measuring 9 mm in size on the posterior mitral leaflet shown on transthoracic echocardiogram (A, arrow), and diffuse stenosis of the posterolateral branch of the right coronary artery shown on coronary angiogram (B, arrow).

Reference

1. Falanga A, Ofosu FA, Delaini F, Oldani E, Dewar L, Lui L, et al. The hypercoagulable state in cancer patients: evidence for impaired thrombin inhibitions. Blood Coagul Fibrinolysis. 1994; 5:Suppl 1. S19–S23.

2. Dipasco PJ, Misra S, Koniaris LG, Moffat FL Jr. Thrombophilic state in cancer, part I: biology, incidence, and risk factors. J Surg Oncol. 2011; 104:316–322.

3. Glassman AB. Hemostatic abnormalities associated with cancer and its therapy. Ann Clin Lab Sci. 1997; 27:391–395.

4. Falanga A, Rickles FR. Pathophysiology of the thrombophilic state in the cancer patient. Semin Thromb Hemost. 1999; 25:173–182.

5. Gross L, Friedberg CK. Nonbacterial thrombotic endocarditis: classification and general description. Arch Intern Med. 1936; 58:620–640.

6. el-Shami K, Griffiths E, Streiff M. Nonbacterial thrombotic endocarditis in cancer patients: pathogenesis, diagnosis, and treatment. Oncologist. 2007; 12:518–523.

7. Lopez JA, Ross RS, Fishbein MC, Siegel RJ. Nonbacterial thrombotic endocarditis: a review. Am Heart J. 1987; 113:773–784.

8. Borowski A, Ghodsizad A, Cohnen M, Gams E. Recurrent embolism in the course of marantic endocarditis. Ann Thorac Surg. 2005; 79:2145–2147.

9. Chino F, Kodama A, Otake M, Dock DS. Nonbacterial thrombotic endocarditis in a Japanese autopsy sample: a review of eighty cases. Am Heart J. 1975; 90:190–198.

10. Taniyama D, Yamamoto R, Kawasaki M, Kamata H, Miyamoto K, Mashimo S, et al. Nonbacterial thrombotic endocarditis leading to acute heart failure due to aortic stenosis in a patient with lung cancer. Intern Med. 2013; 52:1617–1620.

11. Sorensen HT, Mellemkjaer L, Olsen JH, Baron JA. Prognosis of cancers associated with venous thromboembolism. N Engl J Med. 2000; 343:1846–1850.

12. Caine GJ, Stonelake PS, Lip GY, Kehoe ST. The hypercoagulable state of malignancy: pathogenesis and current debate. Neoplasia. 2002; 4:465–473.

13. Connolly GC, Dalal M, Lin J, Khorana AA. Incidence and predictors of venous thromboembolism (VTE) among ambulatory patients with lung cancer. Lung Cancer. 2012; 78:253–258.

14. Young A, Chapman O, Connor C, Poole C, Rose P, Kakkar AK. Thrombosis and cancer. Nat Rev Clin Oncol. 2012; 9:437–449.