2018 Volume 32 Issue 2 Pages 250-255
We report a surgical case of lung cancer with pulmonary embolism confirmed during induction chemotherapy. A 73-year-old woman was referred to our hospital for the examination of a pulmonary opacity. Computed tomography (CT) showed a 25-mm tumor in the right S8 and mediastinal lymphadenopathy. We performed a biopsy of the subcarinal lymph node by endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA), leading to a diagnosis of lung adenocarcinoma, cStageIIIA. She subsequently received induction chemotherapy (Cisplatin, Pemetrexed, and Bevacizumab). After 3 courses, she underwent CT. It showed broadly ranging pulmonary thrombosis on the right side and deep venous thrombosis. The pulmonary thrombosis was distant from the primary tumor.
At that time, D-dimer suddenly rose, but there was nothing of note. She received anticoagulant therapy for 33 days and we could perform lobectomy for lung cancer. There was no postoperative complication. Pulmonary thrombosis often occurs in patients undergoing chemotherapy. We should always keep the possibility of its development in mind.
