Virmani R, Popovsky M A, Roberts W C
Am J Med. 1979 Sep;67(3):498-506. doi: 10.1016/0002-9343(79)90800-3.
Clinical and morphologic findings are described in a 22 year old man with prolonged thromboyctosis, and coronary and splenic arterial thrombi causing myocardial and splenic infarcts. The absence of preexistent extensive coronary atherosclerosis, the presence of thrombus in more than one epicardial artery and in multiple intramural coronary arteries, the presence of arterial thrombosis in a noncoronary artery (splenic) and the absence of another apparent cause of the arterial thromboses are evidences that the intraarterial clotting in this patient was related to the severe thrombocytosis. A reveiw of the reported cases of vascular occlusion associated with thrombocytosis indicates that thrombi have infrequently been confirmed as the mechanism of the vascular occlusion. Although the frequency of vascular thrombi in patients with thrombocytosis has not been established, it is clear that vascular thrombosis can be a consequence of thrombocytosis and, as demonstrated by the present patient, that the coronary artery may be the site of the vascular occlusion, a heretofore unconfirmed event.
本文描述了一名22岁男性患者的临床及形态学表现，该患者存在长时间血小板增多症，伴有冠状动脉及脾动脉血栓形成，导致心肌梗死和脾梗死。患者不存在先前广泛的冠状动脉粥样硬化，多个心外膜动脉及多条壁内冠状动脉存在血栓，非冠状动脉（脾动脉）存在动脉血栓形成，且无其他明显的动脉血栓形成原因，这些证据表明该患者的动脉内凝血与严重血小板增多症有关。对报道的与血小板增多症相关的血管闭塞病例的回顾表明，血栓很少被确认为血管闭塞的机制。尽管血小板增多症患者血管血栓形成的频率尚未确定，但很明显血管血栓形成可能是血小板增多症的结果，并且如本患者所示，冠状动脉可能是血管闭塞的部位，这是迄今为止尚未得到证实的情况。
