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原发性心脏肿瘤。50例临床及组织学表现

Primary neoplasms of the heart. Clinical and histological presentation of 50 cases.

作者信息

Fernandes F, Soufen H N, Ianni B M, Arteaga E, Ramires F J, Mady C

机构信息

Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo.

出版信息

Arq Bras Cardiol. 2001 Mar;76(3):231-7. doi: 10.1590/s0066-782x2001000300006.

Abstract

OBJECTIVE

To analyze clinical and histologic findings of 50 patients with primary neoplasms of the heart in a tertiary referral center.

METHODS

From 1980 to 1998, we retrospectively analyzed 50 patients, 32 of whom were females, whose ages ranged from 9 to 73 years (mean age = 44.16+/-18 years).

RESULTS

Most tumors were located in the left side of the heart (72%), myxoma being the most common (84%) histologic type. The other histologic types found were as follows: fibroma (4%), lipoma (2%), rhabdomyosarcoma (2%), hemangioma (2%), sarcoma (2%), angiosarcoma (2%), and lymphoma (2%). Diagnosis was established by echocardiography in 94% of the cases. Clinical findings were as follows: dyspnea (36%), weight loss (20%), palpitations (18%), chest pain (16%), fever (8%), and arthralgia (6%). All patients with thromboembolic phenomena (10%) had left atrial myxoma. Approximately 20% of the patients were asymptomatic at the initial clinical assessment.

CONCLUSION

Primary cardiac tumors are a rare entity with diverse clinical and histologic findings, requiring, therefore, a high level of clinical suspicion.

摘要

目的

分析一家三级转诊中心50例原发性心脏肿瘤患者的临床和组织学检查结果。

方法

1980年至1998年,我们回顾性分析了50例患者,其中32例为女性,年龄9至73岁(平均年龄 = 44.16±18岁)。

结果

大多数肿瘤位于心脏左侧(72%),黏液瘤是最常见的组织学类型(84%)。发现的其他组织学类型如下:纤维瘤(4%)、脂肪瘤(2%)、横纹肌肉瘤(2%)、血管瘤(2%)、肉瘤(2%)、血管肉瘤(2%)和淋巴瘤(2%)。94%的病例通过超声心动图确诊。临床表现如下:呼吸困难(36%)、体重减轻(20%)、心悸(18%)、胸痛(16%)、发热(8%)和关节痛(6%)。所有有血栓栓塞现象的患者(10%)均患有左心房黏液瘤。约20%的患者在初次临床评估时无症状。

结论

原发性心脏肿瘤是一种罕见疾病,具有多样的临床和组织学表现,因此需要高度的临床怀疑。

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