Subcutaneous nodules at the injection site of low-molecular-weight heparin: A mimic of metastatic disease at CT Journal Article
| Authors: | Funt, S. A.; Hidalgo, A.; Panicek, D. M. |
| Article Title: | Subcutaneous nodules at the injection site of low-molecular-weight heparin: A mimic of metastatic disease at CT |
| Abstract: | Purpose: To describe the appearance and prevalence of subcutaneous nodules in the anterior abdominal wall seen at CT in cancer patients receiving subcutaneous injections of low-molecular-weight heparin (LMWH). Methods: CT examinations were reviewed in 426 patients receiving subcutaneous abdominal wall injections of LMWH for the presence of nodules. Nodules were evaluated for contour, maximal diameter, CT attenuation, and presence of hazy changes or air in the surrounding fat. Results: Fourteen (3%) of the 426 patients had nodules attributable to subcutaneous injections of LMWH. Findings included poorly defined borders (100%), adjacent hazy soft tissue changes (100%), adjacent air (57%), and a mean CT attenuation of -4.4 HU (range: -50-40 HU). Three (0.7%) of 426 patients had nodules caused by metastatic disease. One (33%) nodule had poorly defined borders, two (67%) had surrounding hazy changes, one (33%) had air in adjacent tissue, and there was a mean CT attenuation of 44 HU (range: 14-140 HU). One (0.2%) patient had a subcutaneous nodule of uncertain etiology. Conclusion: Patients receiving subcutaneous injections of LMWH may develop nodules at the injection sites. Such nodules can resemble metastatic tumor deposits at CT, and careful correlation with clinical history and growth trends of metastatic deposits elsewhere in the patient is needed to avoid misdiagnosis. |
| Keywords: | adult; clinical article; controlled study; aged; aged, 80 and over; middle aged; retrospective studies; pancreas cancer; adenocarcinoma; computer assisted tomography; ovary cancer; breast cancer; diagnosis, differential; lung cancer; tomography, x-ray computed; medical assessment; prostate cancer; sarcoma; colon cancer; lymphoma; diagnostic error; stomach cancer; injections, subcutaneous; soft tissue neoplasms; injection site; low molecular weight heparin; drug eruptions; dalteparin; subcutaneous nodule; hypersensitivity, delayed; heparin, low-molecular-weight; humans; human; male; female; priority journal; article; abdominal muscles |
| Journal Title: | Journal of Computer Assisted Tomography |
| Volume: | 26 |
| Issue: | 4 |
| ISSN: | 0363-8715 |
| Publisher: | Lippincott Williams & Wilkins |
| Date Published: | 2002-07-01 |
| Start Page: | 520 |
| End Page: | 523 |
| Language: | English |
| DOI: | 10.1097/00004728-200207000-00007 |
| PUBMED: | 12218812 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Export Date: 14 November 2014 -- Source: Scopus |
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