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V.-jugularis-Thrombose aufgrund eines neuroendokrinen nichtkleinzelligen Lungenkarzinoms

Jugular vein thrombosis caused by a neuroendocrine non-small cell lung cancer

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Zusammenfassung

Ein 65-jähriger Patient stellte sich mit einer ausgedehnten Schwellung im lateralen Halsbereich vor. Die B-Bild-Sonographie ergab eine ovale, scharf begrenzte, hypoechotische Formation von der Schädelbasis bis zur V. subclavia. Computertomographisch wurde die Ursache dafür, eine die V. cava superior komprimierende mediastinale Raumforderung, identifiziert. Histologisch zeigte sich ein nichtkleinzelliges neuroendokrin aktives Bronchialkarzinom. Therapeutisch erfolgte eine Hochdosis-Heparingabe, Antibiose und palliative Chemotherapie.

Bei Raumforderungen im Halsbereich müssen differenzialdiagnostisch kongenitale, infektiöse, neoplastische und sekundäre Ursachen aufgrund von Erkrankungen in anderen Körperregionen berücksichtigt werden. Ätiologien für Jugularvenenthrombosen sind zentrale Venenkatheter, Traumata, Obstruktion und Infektion sowie Hyperkoagulabilität. Für die Diagnosestellung von Raumforderungen in der Kopf-Hals-Region müssen bei fehlender lokaler Ursache sukzessive benachbarte Körperregionen einbezogen werden.

Abstract

A 65-year-old patient presented with extensive swelling of the lateral neck. B-mode ultrasound showed an oval, well defined, hypoechoic formation consisting of multiple circular layers extending from the base of the scull to the subclavian vein. On subsequent computed tomography the size of the lesion was confirmed and the cause, a mediastinal mass compressing the superior caval vein, was identified. Histological examination of the mass revealed a neuroendocrine active non-small-cell-cancer of the lung. Treatment with high-dose heparin and antibiotics was started immediately, combined with palliative chemotherapy.

The differential diagnosis of neck masses includes congenital, infectious, neoplastic and secondary causes due to disease in other regions of the body. Etiologies for jugular vein thrombosis include prolonged central venous catheterization, trauma, obstruction, infection as well as hypercoagulation. In order to diagnose masses in the head and neck region, other parts of the body need to be successively included if no local cause can be identified.

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Authors and Affiliations

  1. Hals-Nasen-Ohren-Klinik und Poliklinik, Charité-Universitätsmedizin Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, 12200, Berlin, Deutschland

    A.E. Albers

  2. Klinik und Poliklinik für HNO-Heilkunde, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Lübeck, Deutschland

    C. Brocks & B. Wollenberg

Authors
  1. A.E. Albers
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  2. C. Brocks
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  3. B. Wollenberg
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Correspondence to A.E. Albers.

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Albers, A., Brocks, C. & Wollenberg, B. V.-jugularis-Thrombose aufgrund eines neuroendokrinen nichtkleinzelligen Lungenkarzinoms. HNO 58, 297–300 (2010). https://doi.org/10.1007/s00106-009-2029-6

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  • DOI: https://doi.org/10.1007/s00106-009-2029-6

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