Spontaneous idiopathic pulmonary vein thrombosis successfully treated with Warfarin: A case report and review of the literature

Abstract

Pulmonary veins (PVs) are the most proximal source of arterial thromboembolism. Pulmonary vein thrombosis (PVT) is an uncommon clinical condition that can be fatal. Its incidence or prevalence is unclear as existing cases are case reports. It is often seen as a complication of malignancy, lobectomy, atrial fibrillation and less commonly idiopathic. It can be diagnosed using different types of non-invasive imaging studies. We present a 68-year-old woman who was undergoing treatment for recurrent urinary tract infection (UTI) but was incidentally noted to be dyspneic and intermittently hypoxic. She was found to have idiopathic pulmonary vein thrombosis that was successfully managed with systemic anticoagulation.

Diffuse arterial embolization secondary to pulmonary vein thrombosis

“…Lung resection is often performed to treat malignancy or external compression [ 3 ]. Anticoagulation is initiated unless contraindicated [ 7 ]. There are case reports of resolution of thrombus with the use of dabigatran [ 11 ] and warfarin [ 7 ].…”

“…Anticoagulation is initiated unless contraindicated [ 7 ]. There are case reports of resolution of thrombus with the use of dabigatran [ 11 ] and warfarin [ 7 ]. Antibiotics are generally given prophylactically [ 3 ].…”

“…The pulmonary veins transport oxygenated blood from the pulmonary circulation into the left side of the heart and subsequently into systemic arterial circulation. Pulmonary vein thromboses (PVT) is a described complication of lung malignancy [ 1 ], lung resections [ 2 ], lung transplantation [ 3 ], thoracic surgical intervention [ 2 ], radiofrequency ablation treatment for atrial fibrillation [ 4 ], polycythemia vera [ 5 ], COVID [ 6 ] or can even develop spontaneously [ 7 ]. The development of pulmonary vein thrombosis (PVT) can be complicated by clot dislodgement into the arterial circulation and subsequent arterial systemic embolic phenomenon with infarcts visualized in numerous organs.…”

A Unique Presentation of Pulmonary Vein Thrombosis in a Patient With Rapidly Progressive Metastatic Pelvic Myxofibrosarcoma

“…PVT is a rare but potentially life-threatening condition with unclear incidence, as much of the literature stems from case reports [1][2][3][4][5][6]. In the published literature, PVT has most commonly been associated as a known complication of pulmonary lobectomy, lung transplant, radiofrequency ablation, and extracorporeal membrane oxygenation (ECMO), with rare reported cases of primary and secondary lung tumors.…”

“…Pulmonary vein thrombosis (PVT) is an uncommon but potentially lethal disease associated with a broad spectrum of conditions ranging from primary malignancy to radiofrequency ablation. This condition poses diagnostic challenges to clinicians due to non-specific presentations and the occasional need for multimodal imaging strategies for definitive diagnosis [ 1 ]. While previous case reports of PVT secondary to sarcoma, namely osteosarcoma and liposarcoma, have previously been published, herein we present a unique case of PVT secondary to high-grade, rapidly progressive, metastatic pelvic myxofibrosarcoma (MFS) in an elderly patient.…”