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Park and Lee: Pulmonary Thromboembolism in Patients with Malignancy
Chest Radiology

Journal of the Korean Society of Radiology 2014; 71(1): 14-19.

Published online: 3 July 2014

DOI: https://doi.org/10.3348/jksr.2014.71.1.14

Pulmonary Thromboembolism in Patients with Malignancy

Gyeong Cheon Park, MD, Jae Kyo Lee, MD

Department of Radiology, College of Medicine, Yeungnam University, Daegu, Korea.

Corresponding author: Jae Kyo Lee, MD. Department of Radiology, College of Medicine, Yeungnam University, 170 Hyeonchung-ro, Nam-gu, Daegu 705-717, Korea. Tel. 82-53-620-3046, Fax. 82-53-653-5484, stallin64@naver.com

Received 27 January 2014       Accepted 9 May 2014

Copyright © 2014 The Korean Society of Radiology

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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.

Keywords: Pulmonary Thromboembolism, Pulmonary Embolism, Malignancy, Neoplasm, Computed Tomography

Figures and Tables

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.
jksr-71-14-g001
Table 1
Numbers of the Patients in Each Group Classified by the Presense of Clinical Presentation, Level of Involved Vessels and the Presence of DVT
jksr-71-14-i001

Note.-*p = 0.904, unchecked patients were excluded.

DVT = deep vein thrombosis

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