Structural changes of the skeletic muscles in phlebotromosis in cancer patients

Abstract

Introduction. In most cancer patients, pulmonary embolism occurs as a result of deep vein thrombosis or pelvis. Among its most probable causes are: prolonged immobilization of patients, endothelial dysfunction, hypercoagulation caused by the procoagulative activity of tumor cells, chemotherapy, surgery and the like. It is now an open question to participate in the pathogenesis of acute lower extremity deep vein thrombosis in cancer patients with structural changes in skeletal muscle. The aim of the study. To evaluate the structural changes of skeletal muscle in deep vein thrombosis of cancer patients. Material and methods. Optical histological and polarization studies were performed using the standard technique for the production and staining of hematoxylin and eosin 54 necropsies of skeletal muscle, which died from cardiopulmonary shock of patients with colon cancer. In addition to necropsy analysis, histologic and polarization studies of skeletal muscle biopsies and electron microscopic endothelial cells were obtained from various topographic areas of the lower extremity in 12 operations for acute ascending thrombophlebitis in patients with colon cancer. In parallel, all patients were determined to determine the number of free-circulating endothelial cells in the citrate blood by J. Hladovez method, in modification Sivak V.V. et al. Research results. Histological examination of necropsies and biopsies of the muscular tissue of the lower extremities in colon cancer revealed degenerative changes of endothelial cells, their desquamation with the “exposure of the basement membrane”, which we consider to be the root cause of hemodynamic disorders: full -blooded arteriolar and interiostricular dystocia. Heterogeneous manifestations of remodeling of striated muscle fibers were observed, mainly manifested by varying degrees of atrophic-hypertrophic changes, homogenization of sarcoplasm with myocytolysis, and contracture lesions. Therefore, given that the muscles of the lower extremities, because of their contractile capacity, play an essential role in providing venous hemodynamics, the complex of detected changes can be considered as an important complementary link in the pathogenesis of venous insufficiency in cancer patients and the development of their thrombotic complications. Conclusions. In colon cancer against a background of hemodynamic disorders, expressed by degenerative lesions of endothelial cells with their desquamation, plethora of venules with dystonia of their lumen, interstitial and perivascular edema, heterogeneous manifestations of remodeling, and contracture changes, homogenization of sarcoplasm with myocytolysis.