Mukherjee S K, Panthagani A, Ramroop N, Al-Dujaily S
Urology Department, Basildon & Thurrock University Hospital, Basildon, UK.
BMJ Case Rep. 2012 Sep 7;2012:bcr1120115196. doi: 10.1136/bcr.11.2011.5196.
A 65-year-old gentleman with a previous history of pulmonary embolus presented with a subacute onset of shortness of breath, haemoptysis and chest pain associated with a swollen left leg. Ultrasound Doppler scanning of the leg revealed no deep-vein thrombosis. Thereafter, a CT scan of the pulmonary vasculature revealed a large right-sided pulmonary embolus. CT scanning of the abdomen and pelvis was performed to look for evidence of an intra-abdominal source of thrombus and revealed evidence of a moderate sized pelvic mass causing obstructive uropathy. Urological review of the patient revealed a hard prostate and raised prostate specific antigen, consistent with a diagnosis of primary prostatic carcinoma, which after investigation with a radioisotope bone scan was found to have metastasised to the bony pelvis.
一位65岁男性，既往有肺栓塞病史，此次因亚急性起病的气短、咯血、胸痛伴左腿肿胀就诊。腿部超声多普勒扫描未发现深静脉血栓形成。此后，肺部血管CT扫描显示右侧有一大块肺栓塞。行腹部和盆腔CT扫描以寻找腹内血栓来源的证据，结果显示有一中等大小盆腔肿块，导致梗阻性尿路病。对该患者进行泌尿外科检查发现前列腺质地硬且前列腺特异性抗原升高，符合原发性前列腺癌的诊断，经放射性核素骨扫描检查后发现已转移至骨盆骨。
