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[特鲁索综合征非小细胞肺癌患者急性脑梗死的临床及影像学特征]

[Clinical and Imaging Features of Acute Cerebral Infarction 
in Non-small Cell Lung Cancer Patients with Trousseau Syndrome].

作者信息

Yuan Tengfei, Wang Junping

机构信息

Department of Radiology, Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, 
Tianjin 300052, China.

出版信息

Zhongguo Fei Ai Za Zhi. 2021 Jan 20;24(1):13-18. doi: 10.3779/j.issn.1009-3419.2021.102.01.

Abstract

BACKGROUND

Acute cerebral infarction is a form of Trousseau syndrome (TS), but is relatively rare and often overlooked by clinicians. The aim of this study was to investigate the clinical, laboratory and imaging features of acute cerebral infarction in non-small cell lung cancer (NSCLC) patients with TS.

METHODS

Clinical data, laboratory examination and imaging data of 25 NSCLC patients with TS presented with acute cerebral infarction were collected retrospectively for analysis.

RESULTS

Of the 25 patients, 18 males and 7 females, aged 39-78 years old, including 22 cases of adenocarcinoma, 2 cases of squamous cell carcinoma, and 1 case of large cell carcinoma; all patients had clinical symptoms and signs of acute cerebral infarction; plasma D-dimer was significantly increased, and prothrombin time and activated partial thromboplastin time were shortened to varying degrees; all patients showed acute multiple cerebral infarction foci involving multiple intracranial arterial blood supply areas on plain head magnetic resonance imaging (MRI) [diffusion-weighted imaging (DWI) sequence], the blood supply vessel lumen corresponding to the infarction foci did not show moderate to severe stenosis on the head MR angiography (MRA).

CONCLUSIONS

NSCLC with multiple acute cerebral infarctions is a rare manifestation of TS, which is characterized by multiple acute cerebral infarctions involving multiple arterial blood supply areas with significant hypercoagulability. Improving the early understanding of this disease can provide some help for clinical diagnosis and treatment.

摘要

背景

急性脑梗死是一种特鲁索综合征(TS)的表现形式,但相对少见,常被临床医生忽视。本研究旨在探讨非小细胞肺癌(NSCLC)合并TS患者急性脑梗死的临床、实验室及影像学特征。

方法

回顾性收集25例NSCLC合并TS且出现急性脑梗死患者的临床资料、实验室检查及影像学资料进行分析。

结果

25例患者中,男性18例,女性7例,年龄39 - 78岁,其中腺癌22例,鳞癌2例,大细胞癌1例;所有患者均有急性脑梗死的临床症状和体征;血浆D - 二聚体显著升高,凝血酶原时间及活化部分凝血活酶时间不同程度缩短;所有患者头颅磁共振成像(MRI)[弥散加权成像(DWI)序列]均显示急性多发性脑梗死灶,累及多个颅内动脉供血区,梗死灶对应的供血血管腔在头颅磁共振血管造影(MRA)上未显示中至重度狭窄。

结论

NSCLC合并多发性急性脑梗死是TS的一种罕见表现,其特征为累及多个动脉供血区的多发性急性脑梗死及明显的高凝状态。提高对本病的早期认识可为临床诊断和治疗提供一定帮助。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/18b7/7849036/a9d517312d0d/zgfazz-24-1-13-1.jpg

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