Wakasa Shiho, Hayashi Hiroya, Yamazaki Takanori, Izumiya Yasuhiro, Fukuda Daiju
Department of Cardiovascular Medicine Osaka Metropolitan University Graduate School of Medicine Osaka Japan.
Clin Case Rep. 2023 Sep 28;11(10):e7975. doi: 10.1002/ccr3.7975. eCollection 2023 Oct.
Contrast defects in veins are often diagnosed as benign thrombi, but depending on the patient's background it is necessary to differentiate between tumor thrombi. It is difficult to differentiate between these using contrast-enhanced CT alone, but with angioscopy it is easy to visually distinguish between a benign and tumor thrombi.
Contrast-enhanced computer tomography (CT) performed on a male patient being treated for de-differentiated chondrosarcoma revealed contrast defects in the pulmonary artery and right femoral vein, and a diagnosis of pulmonary artery thromboembolism and venous thromboembolism was made, and oral anticoagulant therapy was started. However, a follow-up CT showed that the contrast defect had extended to the inferior vena cava. Observation using an angioscope revealed that it was not a benign thrombi but a tumor.
静脉内的造影剂充盈缺损常被诊断为良性血栓，但根据患者背景，有必要鉴别肿瘤血栓。仅使用增强CT很难区分两者，但通过血管内镜检查很容易在视觉上区分良性血栓和肿瘤血栓。
对一名正在接受去分化软骨肉瘤治疗的男性患者进行的增强计算机断层扫描（CT）显示肺动脉和右股静脉存在造影剂充盈缺损，诊断为肺动脉血栓栓塞和静脉血栓栓塞，并开始口服抗凝治疗。然而，后续CT显示造影剂充盈缺损已扩展至下腔静脉。血管内镜观察显示这不是良性血栓，而是肿瘤。
