Lung cancer surgery in a patient with idiopathic thrombocytopenic purpura (ITP)

Abstract

A 59-year-old woman was hospitalized due to an abnormal chest X-ray film. Chest X-ray examination revealed an irregular opacity in the right S6 area. Adenocarcinoma was diagnosed by bronchoscopic exfoliative cytology. Preoperative hematology tests showed a low platelet count and further investigation suggested the presence of idiopathic thrombocytopenic purpura. Preoperative high-dose immunoglobulin therapy (400 mg/kg/day for five days) and platelet transfusion allowed the operation to be performed successfully (resection of the inferior lobe of the right lung and removal of regional lymphnodes). High-dose immunoglobulin therapy is thought to be a very useful method with few adverse effects for the rapid increase of platelet count to prevent massive hemorrhage.