title: Gastric signet-ring cell adenocarcinoma presenting with left arm deep-vein thrombosis and bilateral chylothorax.
abstract: A 28-year-old housewife, a life-long nonsmoker, presented with 3 weeks of pleuritic chest pain along with swollen right leg, left arm, and left breast. Six months previously she had left subclavian vein thrombosis. On admission, bilateral supraclavicular lymphedema on right leg and left arm and breast was observed and bilateral pleural fluid, chylous exudates, was detected. Abdomen computed tomography revealed abundant ascites and right ovarian enlargement. Whole body bone scintigraphy showed bone metastases on left humerus, right femur, and pelvis. Bronchial biopsy, obtained from edematous, hyperemic-irregular mucosa, revealed a carcinoma composed of signet-ring cells with intracytoplasmic mucin. Breast biopsy also showed signet-ring cells within the lymphatics. Pleural fluid cytology showed similar malignant cells. The patient was diagnosed as gastric signet-ring cell adenocarcinoma with endobronchial, mammary, ovarian, pleural, pericardial, peritoneal, and osteal metastases. The authors recommend that deep-vein thrombosis in unusual sites deserves further evaluation for an occult malignancy.
authors.affiliation: Department of Chest Diseases, Ankara University School of Medicine, Ankara, Turkey.
authors.forename: Oya
authors.initials: O
authors.lastname: Kayacan
authors.forename: Demet
authors.initials: D
authors.lastname: Karnak
authors.forename: Berna
authors.initials: B
authors.lastname: Ayşe Can
authors.forename: Serpil
authors.initials: S
authors.lastname: Dizbay Sak
authors.forename: Sumru
authors.initials: S
authors.lastname: Beder
mesh_terms: D000328:Adult; D001132:Arm / Q000098:blood supply; D018279:Carcinoma, Signet Ring Cell / Q000150:complications*; D002916:Chylothorax / Q000209:etiology*; D005260:Female; D006801:Humans; D013274:Stomach Neoplasms / Q000150:complications*; D020246:Venous Thrombosis / Q000209:etiology*