Antineoplastics Pulmonary emboli: case report

The association between induction chemotherapy of non-Hodgkin 's lymphoma and the development of pulmonary embolus has been reported previously [Reactions 223:5, 15 Oct 1988].

Subsequently, a similar case was seen in a man who was receivinq chemotherapy for high grade lymphoma. He was admitted to hospital with a 3 -day history of increasing dyspnoea on exercise. No associated haemoptysis, chest pain of calf swell ing were present , chest x-ray showed bilateral hilar lymphadenopathy attributable to lymphoma and ECG was normal. White blood cell count was 2 x 109/L and haemoglobin 10.2 g/dl. Previous respiratory function tests had shown a decreased transfer factor , which was thought to be related to bleomycin therapy. Although laboratory and clinical findings , apart from breathlessness, did not suggst a diagnosis of pulmonary embolus, a ventilation-perfusion scan was performed . A diagnosis of multiple pulmonary emboli was made and the patient improved markedly on treatment with heparin and warfarin . Chemotherapy was later reinstated. Isles SR. H,ck,sh T. Cunningham D. Chemotherapy related pulmonary embolus recognised British Medical Journal 297 ' 854. Oct 1988

4 REACTIONS" 12 Nov 1988 0157-7271 / 88/ 1112.()()()4/ 0S01 .00/ 0 © ADIS Press