Letter to the Editor
Atypical Deep Venous Thrombosis as the First Manifestation of Pulmonary Neoplasm
Trombosis venosa inusual como primera manifestación de neoplasia pulmonar
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"156" "paginaFinal" => "157" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Soraya Jodra Sánchez, Ana María Andrés Blanco, Laura Abad Manteca" "autores" => array:3 [ 0 => array:4 [ "nombre" => "Soraya" "apellidos" => "Jodra Sánchez" "email" => array:1 [ 0 => "sorayajodra_9@hotmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Ana María" "apellidos" => "Andrés Blanco" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "Laura" "apellidos" => "Abad Manteca" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Servicio de Neumología, Hospital Universitario Río Hortega, Valladolid, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Medicina Interna, Hospital Universitario Río Hortega, Valladolid, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Trombosis venosa inusual como primera manifestación de neoplasia pulmonar" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 601 "Ancho" => 975 "Tamanyo" => 91736 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Bilateral venous thrombosis and malignancy.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Hypercoagulable states in cancer are well known to be closely associated with thromboembolic phenomena. After a thromboembolic event, the incidence of malignant tumors, mainly of the blood, pancreas, ovary, liver, kidney and lung, ranges between 2% and 25%. The most common sites are venous thrombosis of the lower limbs and pulmonary thromboembolism, and reports of cases in other venous territories are unusual.</p><p id="par0010" class="elsevierStylePara elsevierViewall">We report a 68-year-old man, smoker of more than 40 pack-years, who was seen in the ophthalmology clinic for a 20-day history of loss of sight in the right eye. Examination of the eye revealed bilateral venous thrombosis of the retina. Additional examinations were performed to rule out secondary systemic disease. Clinical laboratory, coagulation, serological and autoimmune examinations and computed tomography (CT) of the brain were performed; all results were negative. A chest X-ray was performed, revealing a nodule in the left upper lobe (LUL). Chest CT confirmed a 14<span class="elsevierStyleHsp" style=""></span>mm spiculated nodule in the posterior region of the LUL, indicative of malignancy (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>), and a diagnosis of lung adenocarcinoma was confirmed by the pathology report. No pathological contrast uptake was found in any other sites on PET-CT.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">The merits of extensive screening for occult malignancy after idiopathic thromboembolic events are still widely debated. The latest evidence suggests that this practice is only justified in high-risk patients (recurrent thrombotic events in spite of anticoagulation, and portal or hepatic vein thrombosis) due to high healthcare costs, but basic screening studies with laboratory testing, protocolized according to age and chest X-ray results, may be beneficial.<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">1–4</span></a> Finally, it is important to note that while the most commonly affected territories are the veins of the lower limbs and the lungs, a small percentage of venous thrombosis in unusual sites may also indicate occult malignancy or other systemic diseases. Thus, each case should be evaluated on an individual basis, and minimal basic screening is a possible approach.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Jodra Sánchez S, Andrés Blanco AM, Abad Manteca L. Trombosis venosa inusual como primera manifestación de neoplasia pulmonar. Arch Bronconeumol. 2015;51:156–157.</p>" ] ] "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 601 "Ancho" => 975 "Tamanyo" => 91736 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Bilateral venous thrombosis and malignancy.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:4 [ 0 => array:3 [ "identificador" => "bib0025" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Thrombophilic state in cancer. Part I: Biology, incidence, and risk factors" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "P.J. Dipasco" 1 => "S. Misra" 2 => "L.G. Koniaris" 3 => "F.L. Moffat Jr." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/jso.21925" "Revista" => array:6 [ "tituloSerie" => "J Surg Oncol" "fecha" => "2011" "volumen" => "104" "paginaInicial" => "316" "paginaFinal" => "322" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21480262" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0030" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Systematic review: the Trousseau syndrome revisited: Should we screen extensively for cancer in patients with venous thromboembolism?" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "M. Carrier" 1 => "G. Le Gal" 2 => "P.S. Wells" 3 => "D. Fergusson" 4 => "T. Ramsay" 5 => "M.A. Rodger" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Ann Intern Med" "fecha" => "2008" "volumen" => "149" "paginaInicial" => "323" "paginaFinal" => "333" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18765702" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0035" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Cancer and venous thromboembolism" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "P. Prandoni" 1 => "A. Falanga" 2 => "A. Piccioli" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/S1470-2045(05)70207-2" "Revista" => array:6 [ "tituloSerie" => "Lancet Oncol" "fecha" => "2005" "volumen" => "6" "paginaInicial" => "401" "paginaFinal" => "410" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15925818" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0040" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Trombosis venosa profunda en sitios inusuales y trombosis superficial. Resultados preliminares de una encuesta multicéntrica de la Sociedad Argentina de Hematología" "autores" => array:1 [ 0 => array:2 [ "colaboracion" => "Subcomisión de Hemostasia y Trombosis de la Sociedad Argentina de Hematología" "etal" => false ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Haematologia (Budap)" "fecha" => "2001" "volumen" => "5" "paginaInicial" => "73" "paginaFinal" => "75" ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/15792129/0000005100000003/v2_201502230226/S157921291400411X/v2_201502230226/en/main.assets" "Apartado" => array:4 [ "identificador" => "14576" "tipo" => "SECCION" "es" => array:2 [ "titulo" => "Letters to the editor" "idiomaDefecto" => true ] "idiomaDefecto" => "es" ] "PDF" => "https://static.elsevier.es/multimedia/15792129/0000005100000003/v2_201502230226/S157921291400411X/v2_201502230226/en/main.pdf?idApp=UINPBA00003Z&text.app=https://archbronconeumol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S157921291400411X?idApp=UINPBA00003Z" ]
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