Medical image of the week: metastatic melanoma with hemorrhage

Southwest Journal of Pulmonary and Critical Care

关键词: ground-glass opacities;    complication;    deep venous thrombosis;    hemoptysis;    lung mass;    pulmonary nodules;    warfarin;   

DOI  :  http://dx.doi.org/10.13175/swjpcc079-13

来源: DOAJ

【 摘 要 】

A 62 year-old gentleman presented with right leg swelling due to an extensive DVT in the right femoral vein.He was found to have a right groin mass attributed to metastatic malignant melanoma.Chest x-ray and CT revealed multiple bilateral pulmonary nodules.He was started on warfarin 3mg daily for acute deep venous thrombosis and referred to Oncology.Two weeks later he developed hemoptysis and was found to be hypoxemic.He was admitted to our MICU.His international normalized ratio (INR) upon admission was 8.2 and hemoglobin 6.4 g/dL. CT chest showed innumerable bilateral pulmonary nodules and ground-glass alveolar opacities with thickening and nodularity of intra-lobular septa adjacent to the nodules.Warfarin was held and packed red blood cell and fresh frozen plasma transfusions were given with progressive improvement in hemoptysis and pulmonary status.

【 授权许可】

Unknown