Cerebral Embolism Caused by Thrombus in the Pulmonary Vein Stump after Left Lower Lobectomy: A Case Report and Literature Review

Genki Usui; Yohei Takayama; Hirotsugu Hashimoto; Takehiro Katano; Masahiro Yanagiya; Masashi Kusakabe; Tamaki Miura; Jun Matsumoto; Hajime Horiuchi; Seiji Okubo

doi:10.2169/internalmedicine.1962-18

CASE REPORTS

Cerebral Embolism Caused by Thrombus in the Pulmonary Vein Stump after Left Lower Lobectomy: A Case Report and Literature Review

Genki Usui, Yohei Takayama, Hirotsugu Hashimoto, Takehiro Katano, Masahiro Yanagiya, Masashi Kusakabe, Tamaki Miura, Jun Matsumoto, Hajime Horiuchi, Seiji Okubo

Author information

Genki Usui
Department of Cerebrovascular Medicine, NTT Medical Center Tokyo, Japan
Department of Diagnostic Pathology, NTT Medical Center Tokyo, Japan
Yohei Takayama
Department of Cerebrovascular Medicine, NTT Medical Center Tokyo, Japan
Hirotsugu Hashimoto
Department of Diagnostic Pathology, NTT Medical Center Tokyo, Japan
Takehiro Katano
Department of Cerebrovascular Medicine, NTT Medical Center Tokyo, Japan
Masahiro Yanagiya
Department of General Thoracic Surgery, NTT Medical Center Tokyo, Japan
Masashi Kusakabe
Department of Radiology, NTT Medical Center Tokyo, Japan
Tamaki Miura
Department of Diagnostic Pathology, NTT Medical Center Tokyo, Japan
Jun Matsumoto
Department of General Thoracic Surgery, NTT Medical Center Tokyo, Japan
Hajime Horiuchi
Department of Diagnostic Pathology, NTT Medical Center Tokyo, Japan
Seiji Okubo
Department of Cerebrovascular Medicine, NTT Medical Center Tokyo, Japan

Keywords: stroke, endovascular thrombectomy, lung cancer

JOURNAL OPEN ACCESS

2019 Volume 58 Issue 9 Pages 1349-1354

DOI https://doi.org/10.2169/internalmedicine.1962-18

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Abstract

Cerebral embolism after left upper lobectomy caused by a thrombus in the pulmonary vein stump (PVS) is a serious complication. However, it is unclear if cerebral embolism can develop after other types of lobectomy. We present a case of a 68-year-old man with cerebral embolism after left lower lobectomy with a longer PVS than normal. There were no clinically suspected sources for the thrombus except for the PVS. This thrombus seemed to have formed in the PVS. The endovascularly removed thrombus contained scattered nuclear debris around neutrophils, suggesting a physiological response caused by tissue injury.

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