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Thrombophlebitis migrans
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Thrombophlebitis migrans

Contributors: Paras Vakharia, Amor Khachemoune MD, Susan Burgin MD
Other Resources UpToDate PubMed


Recurrent superficial, or migratory, thrombophlebitis (also known as thrombophlebitis migrans or migratory thrombophlebitis, and Trousseau syndrome) usually presents as recurrent episodes of thrombophlebitis that occur simultaneously or successively in disparate locations of the subcutaneous fat over the trunk and lower extremities. Clinically, tender, erythematous cords or nodules are seen. Pathogenically, local thrombosis develops in superficial blood vessels due to a hypercoagulable state.

There is very high association with malignancies including carcinomas, such as adenocarcinomas of the pancreas and lung carcinomas. Armand Trousseau first reported this phenomenon in 1865 when he commented that unexpected thrombophlebitis could indicate an occult visceral malignancy.

These malignancies are often associated with the development of a hypercoagulable state. The exact mechanism for this is not fully elucidated. However, it is postulated that the tumors may secrete procoagulant factors, such as thromboplastin, that can lead to local clotting.

Related topic: Superficial Thrombophlebitis


I82.1 – Thrombophlebitis migrans

31268005 – Thrombophlebitis migrans

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

  • Deep vein thrombosis / thrombophlebitis of other origin
  • Cellulitis
  • Lymphangitis
  • Soft tissue injury
  • Septic thrombophlebitis
  • Erythema nodosum
  • Hematoma
  • Venous insufficiency / varicose veins
  • Postphlebitic (thrombotic) syndrome
  • Panniculitis
  • Urticaria
  • Contact dermatitis (Allergic contact dermatitis, Irritant contact dermatitis)
  • Eosinophilic cellulitis
  • Lipodermatosclerosis
  • Buerger disease
  • Nodular vasculitis
  • Herpesvirus infections (Herpes simplex virus, Herpetic whitlow, Herpes zoster) may demonstrate lymphangitic streaking
A common pitfall is not ruling out or searching for an underlying malignancy.

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Last Reviewed:12/05/2016
Last Updated:12/05/2016
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Thrombophlebitis migrans
A medical illustration showing key findings of Thrombophlebitis migrans : Erythema, Recurring episodes or relapses, Skin warm to touch, Tender skin lesion
Copyright © 2024 VisualDx®. All rights reserved.