2019 Volume 33 Issue 1 Pages 12-20
Antiphospholipid syndrome (APS) is an acquired autoimmune disease characterized by arterial and/or venous thromboses. Few reports have described patients with APS who have undergone surgery for lung cancer, and the significance is unclear. Case 1: A 75-year-old woman with APS underwent chest computed tomography on follow-up, which showed a 103-mm mass in the right lower lobe and enlarged subcarinal lymph nodes; a diagnosis of squamous cell carcinoma was made. Laboratory tests on admission revealed thrombocytopenia (4.5×104 per cu.mm.). Following platelet transfusion, right lower lobectomy with removal of the regional lymph nodes was performed successfully. Case 2: A 66-year-old man underwent scintigraphy for parathyroid examination, which revealed a 31-mm mass in the left lower lobe; it was diagnosed as squamous cell carcinoma. He was taking aspirin and warfarin for APS and atrial fibrillation. Laboratory tests on admission revealed thrombocytopenia (9.0×104 per cu.mm.), and prolongation of the prothrombin time (37.4 seconds) and activated partial thromboplastin time (47.3 seconds). Before the operation, bridging therapy with unfractionated heparin was administered. Left lower lobectomy with removal of the regional lymph nodes was performed successfully. Surgical treatment for lung cancer patients with APS requires prudent perioperative management.
