在食道腺癌中发生的帕拉尼新生性超纤维素分解:一个病例报告
Yuhui Zhou1, William Gelson2, Rebecca Brais3
1Haematology, Addenbrooke's Hospital, Cambridge University Hospitals National Health Service (NHS) Foundation Trust, Cambridge, GBR.
Cureus
|September 26, 2025
概括
一次性纤维素分解,一种罕见的出血障碍,在患有隐性食道癌的患者中被诊断出. 像ROTEM这样的粘弹性测试对于在标准测试失败时检测这种情况至关重要.
科学领域:
- 在瘤学瘤学.
- 血液学 血液学 血液学
- 病理学 病理学 病理学
背景情况:
- 过纤维素溶解是一种罕见的,危及生命的凝血病.
- 它可以表现为副瘤综合征,经常错过常规检查.
- 需要专门的诊断来检测.
研究的目的:
- 为了呈现一种与隐藏的食道腺癌相关的初级高纤维素分解病例.
- 突出诊断挑战和粘弹性测试的实用性.
- 强调在不明原因出血时怀疑隐性恶性瘤的重要性.
主要方法:
- 一个70多岁的男性患者的病例报告,有出血和消化不良的症状.
- 实验室凝血测试,包括D-二聚合物,纤维素和前血蛋白时间.
- 旋转性血栓弹性测量 (ROTEM) 用于粘弹性评估.
- 图像检查,骨髓活检和横肝活检用于诊断.
主要成果:
- 患者表现为失消,疼痛,伤,D-二次数升高,纤维素素低,PT延长.
- ROTEM证实了高纤维素分解 (60分钟的溶解指数为53%).
- 隐藏的转移性食道腺癌最终是通过肝活检诊断出来的.
结论:
- 这一案例凸显了初级纤维素分解和食道腺癌之间罕见的关联.
- 瘤驱动的纤维解蛋白过度表达是可疑的病理生理学.
- 通过粘弹性测试进行早期识别和对隐性恶性瘤的高度怀疑是非常重要的,因为死亡率很高.
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