A case of primary cardiac lymphoma: Difficult to diagnose.
A case of primary cardiac lymphoma: Difficult to diagnose.
复制标题
原发性心脏淋巴瘤一例：诊断困难。
DOI：
10.1007/s12350-020-02089-1
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发表时间：
2020
期刊：
影响因子：
--
通讯作者：
Hoshiga M.
中科院分区：
文献类型：
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作者：
Maeda D;Kanzaki Y;Sohmiya K;Hoshiga M.
一名61岁的男子被收住到我们医院进一步评估心脏肿块。他主诉进行性劳力性呼吸困难已有数周。经胸超声心动图显示一个大而不均匀的肿块，充满整个右心房（RA）（图1）。氟-18氟脱氧葡萄糖（18 F-FDG）正电子发射断层扫描（PET）/计算机断层扫描（CT）显示RA肿瘤、上级纵隔淋巴结以及右心室和左心室中异常蓄积（图2 A-C）。心脏磁共振成像（MRI）也显示RA肿块的存在，T1黑血技术（BB）上该肿瘤的信号强度均匀等密度; T2 BB上不均匀，轮廓不规则，有浸润性，部分钆增强（图3）。根据这些图像，我们怀疑是血管肉瘤。1在住院的第三天，由于肿瘤快速生长，他的症状恶化并伴有先兆晕厥。他接受化疗（紫杉醇和地塞米松），导致症状逐渐改善，RA肿瘤缩小。进行后外侧胸廓切开术进行肿瘤活检;然而，标本仅显示坏死组织;因此，我们无法做出明确诊断。36天后，重复18F-FDG PET进行随访
A 61-year-old man was admitted to our hospital for further evaluation of a cardiac mass. He had complained of progressive exertional dyspnea for several weeks. Transthoracic echocardiogram revealed a large and inhomogeneous mass that filled the entire right atrium (RA)(Figure 1). Fluorine-18 fluorodeoxyglucose (18F-FDG) positron emission tomography (PET)/computed tomography (CT) revealed abnormal accumulation in the RA tumor, superior mediastinal lymph nodes, and both right and left ventricles (Figure 2 A–C). Cardiac magnetic resonance imaging (MRI) also revealed the presence of RA mass, and the signal intensity of this tumor is homogeneous isodensity on a T1 black-blood technique (BB); heterogeneous on T2 BB with an irregular and invasive contour with partial gadolinium enhancement (Figure 3). Based on these images, we suspected angiosarcoma. 1 On the third hospital day, his symptoms worsened with presyncope due to rapid tumor growth. He underwent chemotherapy (paclitaxel and dexamethasone), resulting in gradually symptomatic improvement and shrinkage of the RA tumor. Posterolateral thoracotomy was performed for tumor biopsy; however, the specimens showed only necrotic tissues; therefore, we could not reach a definitive diagnosis. After 36 days, 18F-FDG PET was repeated for follow-up