Possibility of diagnosis and treatment of thrombotic complications in primary mediastinal B-cell lymphoma

Abstract

Aim. Efficacy of the treatment of primary mediastinal B-cell lymphosarcoma depends to a great extent on early diagnosis and treatment policy. In this study we evaluated possibilities of diagnosis and treatment of thrombotic complications of primary mediastinal B-cell lymphosarcoma (PMBL). Material and methods. 61 patients were examined using roentgenography, computed tomography, chest ultrasound investigation,coagulogram, allelle specific polymerase chain reaction, ultrasound investigation of the jugular, subclavian, brachial veins, vena cava superior to detect mutation of genes II, Vfactors and methylentetrahydrofolatereductase. Results. In 7 cases prechemotherapy examination detected thrombosis of the internal jugular and subclavian veins. In 4 of 7 cases there was a combined thrombosis of the left internal jugular and subclavian veins, in 3 cases one the vessels was affected with thrombosis. In 2 cases, in the course of polychemotherapy, there was recurrent thrombosis and development of pulmonary artery thromboembolism (PATE). In progression of the disease there was thrombosis of the left subclavian vein (1 case) and PA ТЕ (a case). Coagulologically, hypercoagulation syndrome signs were registered. 5 patients with PMBL complicated by thromboses showed gene mutations. Conclusion. In PMBL there is a tendency to formation of venous thrombosis and development of PATE. This is explained by tumor process and hereditary factors of thrombogenicity. Therefore, specific antitumor treatment should include anticoagulation theerapy.

Keywords

• primary mediastinal b-cell lymphosarcoma
• thrombosis of the jugular veins
• thrombosis of the subclavian veins
• pulmonary artery thromboembolism
• activated partial thromboplastic time
• international standards
• methylentetrahydrofolatereductase gene
• prothrombin gene
• leiden's mutation