Background. We study the clinical significance and management of pulmonary venous obstruction in cancer patients. Methods.\nWe conducted a prospective cohort study to characterize the syndrome that we term ââ?¬Å?pulmonary vein obstruction syndromeââ?¬Â\n(PVOS) between January 2005 and March 2014. The criteria for inclusion were (1) episodes of shortness of breath; (2) chest\nX-ray showing abnormal pulmonary hilum shadow with or without presence of pulmonary edema and/or pleural effusion; (3)\nCT scan demonstrating pulmonary vein thrombosis/tumor with or without tumor around the vein. Results. Two hundred and\ntwenty-two patients developed PVOS. Shortness of breath was the main symptom, which was aggravated by chemotherapy in 28\n(13%), and medical/surgical procedures in 21 (9%) and showed diurnal change in intensity in 32 (14%). Chest X-rays all revealed\nabnormal pulmonary hilum shadows and presence of pulmonary edema in 194 (87%) and pleural effusion in 192 (86%). CT scans all\nshowed pulmonary vein thrombosis/tumor (100%) and surrounding the pulmonary veins by tumor lesions in 140 patients (63%).\nPVOS was treated with low molecular weight heparin in combination with dexamethasone, and 66% of patients got clinical/image\nimprovement. Conclusion. Physicians should be alert to PVOS when shortness of breath occurs and chest X-ray reveals abnormal\npulmonary hilum shadows.
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