Abstract
Lung cancer is the leading cause of cancer-related deaths worldwide. Although molecular therapies have emerged as efficacious strategies for the treatment of lung cancer, surgical resection is still recommended as a radical therapeutic option. Currently, lobectomy is regarded as the most reliable radical treatment of primary lung cancer. Among the various complications after lobectomy, cerebral thromboembolism requires attention as a life-threatening complication during the early postoperative period. It occurs in 0.2–1.2% of surgical cases of lung cancer and typically develops following left upper lobectomy with a long pulmonary vein stump (PVS). PVS-associated thrombosis is known to cause cerebral thromboembolism after such procedures; however, distinguishing this specific complication from that caused by postoperative atrial fibrillation is challenging. We summarize herein the diagnostic pathology of thrombus formation in accordance with its thrombogenic mechanism. We focus on the potential utility of the pathological assessment of thrombectomy specimens. The morphological information obtained from these specimens enables the presumption of thrombogenic etiology and provides useful clues to both select an appropriate pharmacotherapy and determine a follow-up treatment for cerebral thromboembolism.
Highlights
Lung cancer is the leading cause of cancer deaths globally [1,2]
Nearly one-half were attributed to nonbacterial thrombotic endocarditis (NBTE) or Disseminated Intravascular Coagulopathy (DIC) [50], which resulted from hypercoagulable states that were attributable, at least in part, to sialomucin produced by an adenocarcinoma [51,52]
Recent studies reported that left atrial appendage occlusion decreases the risk of thromboembolism and improves survival in Atrial Fibrillation (AF) patients undergoing cardiac surgery [63,64]. These findings indicate that AF causes cerebral thromboembolism via thrombus formation in the left atrial appendage
Summary
Lung cancer is the leading cause of cancer deaths globally [1,2]. molecular therapies have emerged as efficacious strategies for the treatment of lung cancer [3,4,5,6], surgical resection is still recommended as a radical therapeutic option. Various complications after lobectomy, including bleeding, infection, atelectasis, air leak, pneumothorax, chylothorax, empyema, and cardiac complications (e.g., atrial fibrillation (AF) and cardiac tamponade) have been observed [9,10,11,12,13,14] Among these complications, cerebral thromboembolism is a life-threatening condition during the early postoperative period, occurring in 0.2–1.2% of surgical lung cancer cases [14,15,16,17,18]. Some may believe that cerebral attributable to Trousseau’s syndrome; various factors affecting the thrombogenic thromboembolism after lung cancer surgery is attributable to Trousseau’s syndrome; various mechanism must be considered.
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