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Cerebral Thromboembolism after Lobectomy for Lung Cancer: Pathological Diagnosis and Mechanism of Thrombus Formation

Department of Diagnostic Pathology, NTT Medical Center Tokyo, Tokyo 141-8625, Japan
Faculty of Healthcare, Tokyo Healthcare University, Tokyo 141-8648, Japan
Division of Pathology, The Cancer Institute, Japanese Foundation for Cancer Research, Tokyo 135-8550, Japan
Department of Comprehensive Pathology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8510, Japan
Authors to whom correspondence should be addressed.
Cancers 2019, 11(4), 488;
Received: 7 March 2019 / Revised: 2 April 2019 / Accepted: 2 April 2019 / Published: 5 April 2019
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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. View Full-Text
Keywords: thrombus; pathology; cerebral thromboembolism; lung cancer; lobectomy thrombus; pathology; cerebral thromboembolism; lung cancer; lobectomy

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Hashimoto, H.; Usui, G.; Tsugeno, Y.; Sugita, K.; Amori, G.; Morikawa, T.; Inamura, K. Cerebral Thromboembolism after Lobectomy for Lung Cancer: Pathological Diagnosis and Mechanism of Thrombus Formation. Cancers 2019, 11, 488.

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