Lee Hyewon, Chung Woo Chul, Lee Kang-Moon, Paik Chang Nyol, Kim Ji Hee, Jeon Hyo Sin, Jun Kyong-Hwa, Chin Hyung Min
Department of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea.
Korean J Gastroenterol. 2012 Jul;60(1):42-6. doi: 10.4166/kjg.2012.60.1.42.
Portal vein thrombus has been detected in patients with liver cirrhosis, pancreatitis, ulcerative colitis, septicemia, myeloproliferative disorder, and neoplasm. The formation of portal tumor thrombus by hepatocellular carcinoma is well recognized, because of its high incidence, and subsequent development of portal hypertension such as rupture of varices, ascites and liver failure indicates the poor prognosis. In gastric cancer, portal hypertension as an initial presentation is extremely rare. Herein we report a case presenting as portal hypertension caused by tumor thrombus without invasion of liver parenchyma. It is presumed to be intraluminal tumor thrombus originating from primary foci of gastric adenocarcinoma. Tumor thrombus in the portal vein is demonstrated on the PET-CT.
门静脉血栓已在肝硬化、胰腺炎、溃疡性结肠炎、败血症、骨髓增殖性疾病和肿瘤患者中被检测到。肝细胞癌形成门静脉肿瘤血栓因其高发生率而广为人知，随后门静脉高压的发展，如静脉曲张破裂、腹水和肝衰竭，提示预后不良。在胃癌中，以门静脉高压为首发表现极为罕见。在此，我们报告一例由肿瘤血栓引起门静脉高压但未侵犯肝实质的病例。推测其为源自胃腺癌原发灶的腔内肿瘤血栓。PET-CT显示门静脉内有肿瘤血栓。
