Journal List > J Korean Soc Radiol > v.71(1) > 1087432

Park and Lee: Pulmonary Thromboembolism in Patients with Malignancy

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.

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.
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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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