Yaoita Kei, Takasaki Toshikazu, Ito Shoko, Kawahata Toshimi, Maemondo Makoto
Division of Pulmonary Medicine, Department of Medicine, Jichi Medical University, Tochigi, JPN.
Division of Hematology, Department of Medicine, Jichi Medical University, Tochigi, JPN.
Cureus. 2024 Oct 1;16(10):e70623. doi: 10.7759/cureus.70623. eCollection 2024 Oct.
Primary lung cancer with acquired hemophilia A is rare. We report a case of large cell neuroendocrine carcinoma (LCNEC) with acquired hemophilia A diagnosed by endobronchial biopsy. A 75-year-old male was admitted to our hospital due to severe anemia and multiple organ failure. Hematomas, prolonged activated partial thromboplastin time, decreased activity of factor VIII, and the presence of serum factor VIII inhibitors led to the diagnosis of acquired hemophilia A. Administration of recombinant activated factor VIII and steroid treatment resolved the coagulation abnormalities. Simultaneously, a CT scan showed a lung mass and an endobronchial biopsy confirmed the diagnosis of LCNEC. Although acquired hemophilia A can cause severe bleeding symptoms, a lung cancer diagnosis by bronchoscopy was possible under appropriate treatment of acquired hemophilia A.
原发性肺癌合并获得性血友病A较为罕见。我们报告一例经支气管活检诊断为大细胞神经内分泌癌（LCNEC）合并获得性血友病A的病例。一名75岁男性因严重贫血和多器官衰竭入住我院。血肿、活化部分凝血活酶时间延长、凝血因子VIII活性降低以及血清凝血因子VIII抑制物的存在导致获得性血友病A的诊断。给予重组活化凝血因子VIII和类固醇治疗后，凝血异常得到缓解。同时，CT扫描显示肺部有肿块，支气管活检确诊为LCNEC。尽管获得性血友病A可导致严重出血症状，但在适当治疗获得性血友病A的情况下，通过支气管镜检查诊断肺癌是可行的。
