Small-cell Lung Cancer Presenting as Fatal Pulmonary Hemorrhage

Lim, Jun Hyeok; Ryu, Jeong-Seon; Cho, Sang Yong; Kim, Hyun-Jung; Jeon, Sang Hoon; Kim, Jung Soo; Nam, Hae-Seong; Cho, Jae Hwa; Kwak, Seung Min; Lee, Hong Lyeol

Small-cell lung cancer (SCLC) represents 15-20% of all lung cancers [1] . SCLC differs from non-small-cell lung cancer in its rapid tumor doubling time, high growth fraction, early development of widespread metastasis, and better response to platinum doublets chemotherapy. Thus chemotherapy is a treatment mainstay, even in poor Eastern Cooperative Oncology Group (ECOG) performance status [2, 3] . Bone marrow involvement or paraneoplastic syndrome is common in patients with SCLC [4] . Hematologic abnormalities such as anemia, leukopenia, and thrombocytopenia are reported to be occasionally accompanied by bone marrow metastasis or paraneoplastic phenomenon [5, 6] . However, complications such as fatal hemorrhage are rarely reported. The clinical presentation can make diagnosis or treatment difficult. Herein, we report an SCLC patient who presented with rapid-onset, refractory severe thrombocytopenia and development of fatal pulmonary hemorrhage.