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Japanese Journal of Clinical Oncology Advance Access published online on June 22, 2006
Japanese Journal of Clinical Oncology, doi:10.1093/jjco/hyl054
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© 2006 Foundation for Promotion of Cancer Research
Received January 13, 2006
Accepted April 7, 2006

Case Report

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

Takeshi Yoshikawa 1 *, Kayo Nakanishi 2, Tsutomu Maruta 3, Daisuke Takenaka 1, Shozo Hirota 4, Shinichi Matsumoto 5, Katsuyasu Saigo 6, Yoshiharu Ohno 1, Masahiko Fujii 1, and Kazuro Sugimura 1

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

* To whom correspondence should be addressed.
Takeshi Yoshikawa, E-mail: yoshikaw{at}med.kobe-u.ac.jp


  Abstract

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.

Keywords: pseudothrombocytopenia; transcatheter arterial embolization; hepatocellular carcinoma; portal invasion.
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