scholarly journals Incidental Finding of Saddle Pulmonary Embolism on a CT Scan of the Abdomen and Pelvis in a Patient With Adenocarcinoma of the Colon

Cureus ◽  
2021 ◽  
Author(s):  
Seyed M Nahidi ◽  
Uzayr Ali ◽  
Leonidha Duka ◽  
Juan C Fuentes-Rosales ◽  
Utpal Bhatt
Keyword(s):  
Pulmonary Embolism ◽  
Ct Scan ◽  
Incidental Finding ◽  
Adenocarcinoma Of The Colon

scholarly journals An incidental finding of testicular seminoma in the context of acute pulmonary embolism: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Kaitlin J. Mayne ◽  
Emma Lewis ◽  
Lewis Vickers
Keyword(s):  
Pulmonary Embolism ◽  
Venous Thromboembolism ◽  
Clinical Guidelines ◽  
Acute Pulmonary Embolism ◽  
Incidental Finding ◽  
White Male ◽  
Vena Cava ◽  
Testicular Seminoma ◽  
Computed Tomography Scanning ◽  
The Right

Abstract Background Clinical guidelines do not recommend further investigation for occult malignancy in the scenario of unprovoked venous thromboembolism in the absence of additional clinical features suggestive of malignancy. We present the case of a young gentleman with pulmonary embolism who was diagnosed with testicular seminoma despite lack of symptoms or signs suggestive of malignancy. This is a unique case describing a scenario not well documented in existing literature where contravention of clinical guidelines had a potentially advantageous outcome for the patient. Case presentation A 37-year-old white male presented with seemingly unprovoked acute pulmonary embolism with right heart strain. He did not have any predisposing factors for venous thromboembolism and did not have any symptoms or signs suggestive of malignancy. Clinical guidelines do not recommend further investigation to screen for malignancy in this scenario. Despite this, our young, otherwise healthy patient proceeded to computed tomography scanning, resulting in the diagnosis of localized testicular seminoma. Testicular ultrasound described normal-sized testes (despite a discrete lesion in the right testis), suggesting this was not detectable by the patient or clinician on routine examination. The patient was anticoagulated and had an inferior vena cava filter inserted to facilitate orchidectomy followed by adjuvant radiotherapy. Conclusions This case highlights the importance of considering malignancy in seemingly unprovoked venous thromboembolism and the availability of guidelines to direct further investigation. Our patient’s treatment was not in line with clinical guidelines and was considered a “lucky find.”

scholarly journals Systematic review and meta-analysis of outcomes in patients with suspected pulmonary embolism

2021 ◽  
Vol 5 (8) ◽  
pp. 2237-2244
Author(s):  
Parth Patel ◽  
Payal Patel ◽  
Meha Bhatt ◽  
Cody Braun ◽  
Housne Begum ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Ct Scan ◽  
Major Bleeding ◽  
Meta Analysis ◽  
Cochrane Central Register ◽  
Suspected Pulmonary Embolism ◽  
Central Register ◽  
Mortality Incidence ◽  
D Dimer

Abstract Prompt evaluation and therapeutic intervention of suspected pulmonary embolism (PE) are of paramount importance for improvement in outcomes. We systematically reviewed outcomes in patients with suspected PE, including mortality, incidence of recurrent PE, major bleeding, intracranial hemorrhage, and postthrombotic sequelae. We searched the Cochrane Central Register of Controlled Trials, MEDLINE, and Embase for eligible studies, reference lists of relevant reviews, registered trials, and relevant conference proceedings. We included 22 studies with 15 865 patients. Among patients who were diagnosed with PE and discharged with anticoagulation, 3-month follow-up revealed that all-cause mortality was 5.69% (91/1599; 95% confidence interval [CI], 4.56-6.83), mortality from PE was 1.19% (19/1597; 95% CI, 0.66-1.72), recurrent venous thromboembolism (VTE) occurred in 1.38% (22/1597; 95% CI: 0.81-1.95), and major bleeding occurred in 0.90% (2/221%; 95% CI, 0-2.15). In patients with a low pretest probability (PTP) and negative D-dimer, 3-month follow-up revealed mortality from PE was 0% (0/808) and incidence of VTE was 0.37% (4/1094; 95% CI: 0.007-0.72). In patients with intermediate PTP and negative D-dimer, 3-month follow-up revealed that mortality from PE was 0% (0/2747) and incidence of VTE was 0.46% (14/3015; 95% CI: 0.22-0.71). In patients with high PTP and negative computed tomography (CT) scan, 3-month follow-up revealed mortality from PE was 0% (0/651) and incidence of VTE was 0.84% (11/1302; 95% CI: 0.35-1.34). We further summarize outcomes evaluated by various diagnostic tests and diagnostic pathways (ie, D-dimer followed by CT scan).

Incidence of Ct scan-detected pulmonary embolism in patients with oncogene-addicted, advanced lung adenocarcinoma

2015 ◽  
Vol 136 (5) ◽  
pp. 924-927 ◽  
Author(s):  
Melina Verso ◽  
Rita Chiari ◽  
Stefano Mosca ◽  
Laura Franco ◽  
Matthias Fischer ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Lung Adenocarcinoma ◽  
Ct Scan

Post-mortem CT scan with contrast injection and chest compression to diagnose pulmonary embolism

2014 ◽  
Vol 41 (1) ◽  
pp. 167-168 ◽  
Author(s):  
Claire Pichereau ◽  
Eric Maury ◽  
Laurence Monnier-Cholley ◽  
Simon Bourcier ◽  
Gabriel Lejour ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Ct Scan ◽  
Chest Compression ◽  
Post Mortem ◽  
Contrast Injection

Syncytio-trophoblast pulmonary embolism: cause of death or incidental finding. Case report and literature review.

2009 ◽  
Vol 17 (4) ◽  
Author(s):  
Mihai Ceausu ◽  
Silvia Dermengiu ◽  
George Cristian Curcă ◽  
Dan Dermengiu ◽  
Lacramioara Luca
Keyword(s):  
Pulmonary Embolism ◽  
Case Report ◽  
Literature Review ◽  
Cause Of Death ◽  
Incidental Finding

scholarly journals Atrial Myxoma? But it’s not

2018 ◽  
Vol 2 (3) ◽  
pp. 155
Author(s):  
AS Nik Ramziyah ◽  
ZA Nor Hidayah ◽  
SR Anas ◽  
M Nazri ◽  
A Nazri ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Incidental Finding ◽  
Emergency Operation ◽  
Right Heart Failure ◽  
Sudden Onset ◽  
Atrial Myxoma ◽  
Right Atrial ◽  
Atrial Thrombus ◽  
Vein Thrombosis ◽  
Right Atrial Thrombus

Postpartum period carries high risk of pulmonary embolism due to hypercoagulability state. Pulmonary embolism (PE) should be suspected in postpartum patient who has short history of progressing right heart failure without underlying heart disease. We report a case of pulmonary embolism with large right atrial thrombus without deep vein thrombosis in a 27 years old lady, para 1+2,post-delivery day 30 who presented with sudden onset of dyspnea and giddiness. She was diagnosed with right atrial thrombus complicated by acute pulmonary embolism. An emergency operation was performed and intraoperatively a pedunculated mobile mass is attached to the right atrial wall mimicking atrial myxoma, with incidental finding of patent foramen ovale. The mass was removed and concomitant pulmonary embolectomy was performed. The postoperative course was uneventful with the patient subsequently discharged.International Journal of Human and Health Sciences Vol. 02 No. 03 July’18. Page : 155-157

scholarly journals Diagnosis of Acute Pulmonary Embolism by Endobronchial Ultrasound as an Incidental Finding

Respiration ◽  
2010 ◽  
Vol 81 (2) ◽  
pp. 150-151 ◽  
Author(s):  
J. Sanz-Santos ◽  
F. Andreo ◽  
I. García-Olivé ◽  
J. Remón ◽  
E. Monsó
Keyword(s):  
Pulmonary Embolism ◽  
Acute Pulmonary Embolism ◽  
Incidental Finding ◽  
Endobronchial Ultrasound

Incidental Finding of Malignancy by CT Angiogram of Chest in Patients Highly Suspected for Pulmonary Embolism.

Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 4089-4089
Author(s):  
Aref Agheli ◽  
Seema Naik ◽  
Alka Arora ◽  
Yelena Yadgarova ◽  
Ashish Sangal ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Comprehensive Evaluation ◽  
Incidental Finding ◽  
Baseline Characteristic ◽  
Additional Information ◽  
Ct Angiogram ◽  
Treatment Type ◽  
Initial Symptoms ◽  
Occult Malignancy ◽  
Recurrent Vte

Abstract Introduction: Venous thromboembolism (VTE), including both pulmonary embolism (PE) and deep venous thrombosis (DVT) is often a silent disease, symptoms are often nonspecific, and the first manifestation may be fatal PE. The link between malignancy itself, and its treatment, type, stage and location, and clinical recurrent VTE has been well recognized since 1865, when Armed Trousseau first reported it. 10–20% of patients with acute VTE have malignancy. VTE may appear before the cancer has become symptomatic and may lead to an earlier diagnosis of cancer; the most common of them include those of the breast, colon, and lung. VTE is the 2nd leading cause of mortality in cancer patients, 2nd only to the cancer itself. Patients with concurrent VTE and malignancy have a more than 3-fold higher risk of recurrent VTE and death, and 4- to 8-fold higher risk of dying after an acute VTE than patients with VTE but no malignancy. Spiral computed tomography angiogram of chest (CTA) was first introduced in 1990s. It has the ability to study pulmonary vessels down to 2-3 mm in diameter and depict PE directly. Only 30–40% of all patients with suspected PE have a confirmed diagnosis. CTA can also provide significant additional information or an alternate diagnosis. Objectives: To determine the frequency of an incidental finding of occult malignancy by CTA of chest in patients highly suspected for PE. Materials and methods: 136 patients, suspected of having PE, were retrospectively studied. We included all the patients, examined by CTA of the chest to diagnose PE from October 2005 through April 2006 at BHMC. We used chart review to evaluate the contribution of CTA to the final clinical diagnosis. The baseline characteristic parameters included age, gender, CTA findings, and pathological examinations. Results: We studied both positive and negative CTA images for searching of evidence of occult malignancy.134 (97.8%) patients had at least one diagnostic finding. Of the 136 patients, highly suspected for PE, 33 (24.3%) patients were confirmed to have PE. A total of 11 (8.1% of total studied) patients were identified with new diagnosis of malignancies. Of these, cancer was detected in 3 (9.1%) patients with PE, and in 8 (7.8%) patients without PE. Thromboembolic risk factors were identified in 2 (66%) patients with positive PE and cancer (e.g. 14 hour flight, immobilization> 3 days). In 63.6% (#7) of patients cancer was diagnosed by initial CTA, and in 36.4% (#4) of patients with follow up studies and clinical evaluations for unresolved initial symptoms during a range of 1 to 7 months (mean of 3.4 months), 3 of the latter group being negative for PE. 72.8% (# 8) of patients had metastatic disease at the time of initial CTA. The most common cancers were gastric adenocarcinoma (# 3, 27.3%), and breast cancer (# 2, 18.2%) of all the patients with cancers. The most common alternative diagnosis other than malignancies, detected by CTA included pleural effusion in 53 (39%) and atelectasis in 48 (35.3%) patients. Only 3 (2.2%) CT angiograms were completely normal. Conclusion: CTA was able to identify occult malignancy in 8.1% of total patients, suspecting PE. Since screening for occult malignancies has been generally underutilized, cancer should be included in the differential etiologies of acute PE, and basic comprehensive evaluation to search for underlying cancer in high-risk patients should be considered.

Sign in / Sign up

Export Citation Format

Share Document