A case of upper left extremity deep vein thrombosis with right side middle lobe syndrome

Abstract

Upper extremity deep vein thrombosis is an extremely important clinical entity with potential for considerable morbidity and mortality. A 64-year-old woman was brought to the emergency department with complaints of left upper limb and neck swelling for 4 days. Ultrasonography of the neck showed thrombosis of the left internal jugular and other surrounding veins associated with local lymphadenopathy. Computed tomography (CT) of the neck also showed a hypodense 0.6 cm × 0.8 cm × 1.2 cm lesion in the right middle lobe bronchus, causing complete occlusion and collapse of the right middle lobe of the lung. Fine-needle aspiration cytology and a lymph node biopsy showed nongranulomatous lymphadenitis. The patient was started on fondaparinux 10 mg subcutaneously once daily. She was discharged on oral anticoagulants for 6 months. Repeat CT scan after 6 months showed dissolution of the lesion and reexpansion of the right lung.

Current Trends in the Duration of Anticoagulant Therapy for Venous Thromboembolism: A Systematic Review

“…A large number of the included articles involved analysis of the studies or sub-studies of the following randomized clinical trials: PADIS-PE, PADIS-DVT, APEX, XALIA, RE-COVER, RE-COVER II, Hokusai-VTE, Hokusai-VTE Cancer, Einstein Choice, Einstein-Extension, PEGeD, ExACT, and VISTA [ 15 - 17 , 20 , 28 , 29 , 36 , 37 , 39 - 44 ]. One case report from India was included that discussed the use of anticoagulants in a female patient with DVT [ 24 ]. Many articles featured a discussion on the use of D-dimer testing as part of the algorithm in deciding anticoagulation duration, and four of those articles were included in this review [ 11 , 12 , 23 , 37 ].…”