Thrombotic pulmonary arteriopathy in polycythemia vera

Pulmonary infarction and hemorrhage are important differential diagnoses in pulmonary coin lesions, especially in patients with underlying hematologic malignancies. We report a 58-year-old female patient suffering from polycy themia vera presenting with multiple pulmonary coin lesions. Open lung biop sy and subsequent histologic investigations showed organized pulmonary infa rction and primary pulmonary thrombotic arteriopathy. Although histologic f eatures are non-contributory in distinguishing organized thrombosis from or ganized thromboembolism, the clinical setting and localization of the lesio ns suggest that in the present case the vascular lesions are due to organiz ed thrombosis.