Mediastinal bleeding

That the combination of thrombolytic therapy with oral anticoagulation and aspirin is potentially fatal, is clearly demonstrated by the development of spontaneous mediastinal bleeding in a case suffering from the Paget von Schroetter syndrome (39 ). 

Fig. 12.1. a A 61-year-old male patient who presented with dyspnea and hemoptysis. Chest X-ray demonstrates mediastinal lymph node enlargement and severe narrowing of the distal trachea, b Computed tomography of the thorax confirms the mediastinal lymph node enlargement and shows infiltration of the trachea by the lymph nodes. Bronchoscopy revealed a tumor of the distal trachea that was found to be an adenocarcinoma at histology. The tumor was bleeding spontaneously, c A spot 1 ... 

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