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Japanese Journal of Clinical Oncology Advance Access originally published online on June 22, 2006
Japanese Journal of Clinical Oncology 2006 36(8):527-531; doi:10.1093/jjco/hyl054
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© 2006 Foundation for Promotion of Cancer Research

Case Report

Anticoagulant-Induced Pseudothrombocytopenia Occurring after Transcatheter Arterial Embolization for Hepatocellular Carcinoma

Takeshi Yoshikawa1, Kayo Nakanishi2, Tsutomu Maruta3, Daisuke Takenaka1, Shozo Hirota4, Shinichi Matsumoto5, Katsuyasu Saigo6, Yoshiharu Ohno1, Masahiko Fujii1 and Kazuro Sugimura1

1 Department of Radiology, Kobe University Graduate School of Medicine, Kobe, 2 Department of Radiology, Miki City Hospital, Miki, Hyogo, 3 Department of Radiology, Himeji Medical Center, Himeji, Hyogo, 4 Department of Radiology, Hyogo College of Medicine, Nishinomiya, Hyogo, 5 Department of Radiology, Tenri Hospital, Tenri, Nara and 6 Blood Transfusion Division, Kobe University Hospital, Kobe, Japan

For reprints and all correspondence: Takeshi Yoshikawa, Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunokicho, Chuoku, Kobe, Hyogo 650-0017, Japan; E-mail: yoshikaw{at}med.kobe-u.ac.jp

Received January 13, 2006; accepted April 7, 2006

Pseudothrombocytopenia (PTCP) is the in vitro phenomenon of anticoagulant-activated platelet agglutination that results in spuriously low platelet counts. We report the case of a 65-year-old man with EDTA- and sodium citrate-dependent PTCP occurring after transcatheter arterial embolization (TAE) for hepatocellular carcinoma (HCC) due to hepatitis C cirrhosis. Invasion of the portal and hepatic veins by HCC formed severe trans-tumoral arterio-venous shunts that were effectively treated by TAE. Two days after the therapy, PTCP was seen on blood count and continued for 4 months. The patient received unnecessary treatment for disseminated intravascular coagulation (DIC) until the diagnosis of PTCP was established. PTCP is a rare complication but should be considered after TAE for HCC; lack of recognition may lead the physician to misdiagnosis and patient mismanagement.

Key Words: pseudothrombocytopenia • transcatheter arterial embolization • hepatocellular carcinoma • portal invasion


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