Lung adenocarcinoma manifested as a pulmonary thromboembolism

摘要

Background. Massive pulmonary thromboembolism as an initial clinical manifestation in patients with peripheral type of lung adenocarcinoma is rare. We report a case of lung cancer demonstrating pulmonary thromboembolism as the initial clinical appearance. Case. A 59-year-old man was admitted to our hospital because of edema and dyspnea. His chest radiograph revealed cardiomegaly and bilateral pleural effusion. Lung perfusion scans showed multiple defects in both lungs. A diagnosis of pulmonary thromboembolism due to deep venous thrombosis was made. He was treated with heparinization and diuretics. However, pleural effusion on the right side increased. The cytological examination revealed adenocarcinoma. Respiratory distress was progressive despite intensive care. He died due to respiratory failure two months after admission. The postmortem examination showed primary lung adenocarcinoma and massive thrombus in the pulmonary artery. Conclusion. Lung cancer preceded by coagulation disorder should be treated with caution.