Medical image of the week: portal vein thrombosis in a patient with polycythemia vera

• Main Authors: Babary H, Maklad M
• Format: Article
• Language: English
• Published: Arizona Thoracic Society 2017-08-01
• Series: Southwest Journal of Pulmonary and Critical Care
• Subjects: polycythemia vera; portal vein; throbmosis; splenic vein; CT scan; acrocyanosis; criteria; major; minor; JAK2V617F
• Online Access: http://www.swjpcc.com/imaging/2017/8/2/medical-image-of-the-week-portal-vein-thrombosis-in-a-patien.html

No abstract available. Article truncated after 150 words. A 39-year-old man with no past medical history presented with acrocyanosis of his left second toe and right upper abdominal pain. Initial labs showed polycythemia, leukocytosis and thrombocytosis that were unchanged with intravenous fluid administration. A CT of the abdomen was obtained and showed portal vein thrombosis without evidence of cirrhosis (Figure 1). Subsequent studies revealed a positive JAK2 V617F mutation and low erythropoietin levels consistent with polycythemia vera (PV). The patient was placed on anticoagulation, low dose aspirin, and received phlebotomy. PV is a chronic myeloproliferative neoplasm defined by an increase in red blood cell mass in the absence of a physiologic stimulus. The 2016 World Health Organization classification of myeloid neoplasms and acute leukemia has three major criteria and one minor criterion in the diagnosis of PV. Diagnosis requires either 3 major criteria or 2 major with 1 minor criterion (1). Major Criteria for Polycythemia Vera: 1. Increased …