Pancreatic cancer

[Alde8127]

I noticed that hemoptysis is a symptom of pancreatic cancer. I thought this happens because, as the cancer grows, it compresses on the nearby blood vessels - but I don't understand how compression of abdominal blood vessels can cause hemoptysis.

Could someone please explain this to me.

Thanks!

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[Alde8127]

Don't take my explanation as perfect, since I just got a question about this the other day and there might be more to it, but my understanding is that you're correct about the vascular compression;

Compression of the splenic vein from an enlarging mass before becoming the portal vein can lead to increased pressure of the short gastric veins, causing varices of the relevant area, i.e. the fundus of the stomach. These can rupture and lead to hemoptysis, similar to the pathogenesis of esophageal varices in cirrhosis.

Yeah that's what I was thinking and I couldn't find much online.
What I was confused about was how this could enter the lungs from the abdominal cavity - it would make sense if it was vomiting blood, but not hemoptysis.

Any ideas?

 

[Alde8127]

Oh wow brain fart I'm sorry, I read that as hematemesis not hemoptysis. I believe that if you have hemoptysis, it wouldn't be from a primary mass but rather a metastasis causing it just as if it were a primary lung cancer.

No worries, thanks for clearing it up!

 

[Like]

“Pancreatic cancer is notoriously aggressive. Indeed, surgically resectable cases on presentation represent the minority: approximately 10% to 15%. Pancreatic neoplasms metastasize by hematogenous and lymphatic routes. Locally, the celiac plexus, superior mesenteric artery, portal vein, and ligament of Treitz are common sites of spread. The liver appears to be the most frequent target of distant metastasis, as well as the peritoneum. The lung is also a common target. Lung metastases were present in greater than 50% of patients with metastatic pancreatic cancer in one study.”

http://jdc.jefferson.edu/cgi/viewcontent.cgi?article=1150&context=tmf

Before I looked it up, I was thinking that it may have had to do migrating thrombophlebitis, but mets is the better answer.

 

[dermpathdoc]

lung mets. Sites of metastasis for Pancreatic cancer in order are, in order, liver, peritoneum & lung/ Pleura.