Pulmonary Artery Thromboembolism as a Complication of Essential Thrombocythemia

Abstract

Essential thrombocythemia (ET) is a chronic myeloproliferative neoplasm characterized by elevated platelet counts and an increased risk of thrombotic or hemorrhagic complications. It typically affects older individuals, with a higher prevalence in women, and is frequently associated with Janus kinase 2 (JAK2) mutations. While many cases follow an indolent course, major thrombotic events such as pulmonary embolism may occur. We report the case of a 72-year-old female patient with a known history of ET who presented with an acute onset of dyspnea and pleuritic chest pain. Computed tomography pulmonary angiography confirmed pulmonary artery thromboembolism. Laboratory tests revealed significant thrombocytosis. The patient was treated with anticoagulation and cytoreductive therapy, resulting in clinical improvement. This case highlights the importance of early recognition of thrombotic complications in patients with ET, even when they are receiving ongoing treatment.

Keywords: essential thrombocythemia (et); hematologic disorder; hypercoagulability; myeloproliferative neoplasm; pulmonary embolism; pulmonary thromboembolism; thrombosis; venous thromboembolism.

Figure 1. CT pulmonary angiography demonstrating pulmonary embolism

CT pulmonary angiography revealed a central filling defect within the right pulmonary artery, consistent with an acute pulmonary embolism. The embolus appears as a sharply demarcated hypoattenuating area within the contrast-enhanced vessel, confirming the presence of an obstructive thrombus. The red arrow highlights this filling defect, which is located in a segmental or lobar branch of the right pulmonary artery, based on anatomical orientation and distribution.