肺癌に合併する非細菌性血栓性心内膜炎の特徴とその意義

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  • Features and Significance of Nonbacterial Thrombotic Endocarditis in Patients with Lung Cancer.

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To examine features and significance of nonbacterial thrombotic endocarditis (NBTE) in patients with lung cancer, we clinicopathologically reviewed 142 autopsied patients with lung cancer. Eleven (7.7%) of the patients had NBTE. Incidence of NBTE was 13%(8/62 cases) in adenocarcinoma and 8.6%(3/35 cases) in squamous cell carcinoma. None of the patients with small cell carcinoma (34 cases) had NBTE. Eleven of the 142 patients had pathologically proved disseminated intravascular coagulation (DIC), and 4 of the 11 patients (36%) also had NBTE. There was significant correlation between DIC and NBTE (p<0.01). Seven of the 11 patients with NBTE had systemic thromboembolism mostly accompanied by infarction. Organs with thromboembolism were as follows: spleen (7 cases), brain (5 cases), kidneys (4 cases), heart (3 cases), and mesentery (2 cases). Multiple, hemorrhagic cerebral infarction (4 cases) was fatal. Myocardial infarction and peritonitis caused by mesenteric arterial embolization also contributed to death. The present study revealed that NBTE occasionally occured in patients with lung cancer and that systemic thromboembolism due to NBTE affected prognosis of the patients. The authors stress that clinicians should keep in mind the features and significance of NBTE in treating patients with lung cancer.

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  • 肺癌

    肺癌 34 (6), 843-852, 1994

    特定非営利活動法人 日本肺癌学会

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