Jugular vein thrombosis associated with distant malignancy

Our plain-English summary of Jugular vein thrombosis associated with distant malignancy, by B.M. Carrington, J.E. Adams (Postgraduate Medical Journal, 1988).

The study

• Authors: B.M. Carrington, J.E. Adams
• Journal: Postgraduate Medical Journal
• Published: 1988;64(752):455-8
• Type of article: Case report
• Cited by: 23 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

We describe two patients who developed internal jugular vein thrombosis associated with primary malignant disease arising outside the neck, and in one patient it was the presenting feature. Computed tomography was performed and the findings characteristic of internal jugular vein thrombosis are illustrated. We conclude that malignant disease should be considered in patients presenting with spontaneous internal jugular vein thrombosis with no other predisposing factors and that computed tomography is of value in confirming the diagnosis.

In plain English

This article reported two patients who developed a blood clot in the internal jugular vein of the neck linked to cancer elsewhere in the body. The authors worked in a radiology department at the University of Manchester, UK. The first patient, a 56-year-old woman, had small bowel carcinoid tumour with lymph node involvement. After surgery she had a clot in the lung, then a right jugular vein clot confirmed by computed tomography (CT). Her symptoms settled without further anticoagulation, and she had no further clots at 8-month follow-up. The second patient, a 59-year-old man, had worked for 31 years as a costing clerk at an asbestos manufacturer, with regular trips onto the factory floor. A left jugular vein clot was his presenting feature. CT showed a pleural mass with the features of mesothelioma, and he died 3 months later. Post-mortem examination confirmed mesothelioma. The article did not name a fiber type or discuss asbestos as a cause. The authors concluded that cancer should be considered in spontaneous jugular vein thrombosis without other causes, and that CT helps confirm the diagnosis.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: case report (two patients)
• Who was studied: Two patients: a 56-year-old woman and a 59-year-old man. The authors were in the Department of Diagnostic Radiology, University of Manchester, UK. Dates of care were not given.
• Exposure: The main subject was cancer arising outside the neck (metastatic small bowel carcinoid; pleural mesothelioma) as a cause of jugular vein thrombosis. The second patient had worked 31 years as a costing clerk at an asbestos manufacturer. No fiber type or dose was given.
• Main results:
  • Case 1 (56-year-old woman): CT confirmed a right internal jugular vein thrombosis after a post-operative pulmonary embolus and the stopping of anticoagulation. Histology showed small bowel carcinoid with nodal involvement.
  • Case 1: blood tests suggested a tendency to clot. Activated partial thromboplastin time was shortened at 23 seconds (control 33 seconds). Platelet count was 617 x 10^9 per litre (normal 150-400).
  • Case 1: symptoms resolved without further anticoagulation, and there were no further thrombotic episodes at 8-month follow-up.
  • Case 2 (59-year-old man, asbestos manufacturer clerk): the left internal jugular vein thrombosis was the presenting feature. CT of the chest showed a pleural soft tissue mass with the features of mesothelioma, and pleural biopsy showed very pleomorphic mesothelial cells.
  • Case 2: the thrombosis extended to the left subclavian vein and responded to anticoagulation. The patient died 3 months later, and post-mortem examination confirmed mesothelioma encasing the base of the left chest and invading the mediastinum. No coagulation abnormality was documented in this patient.
• The authors' conclusion: The authors concluded that the cases illustrate the value of CT in confirming internal jugular vein thrombosis. They also concluded that patients with spontaneous jugular vein thrombosis and no other precipitating cause may have distant malignant disease.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Lung cancer, Mesothelioma.

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