Liu P Y, Tsai W C, Chen J H, Kan C D, Yan J J
Division of Cardiology, Department of Internal Medicine, National Cheng-Kung University Hospital, Tainan, Taiwan.
J Formos Med Assoc. 2001 May;100(5):336-8.
Tuberculous constrictive pericarditis is a rare condition with a high mortality rate. The coexistence of constrictive pericarditis and intracardiac tuberculoma has not previously been reported. We report the case of a 65-year-old man presenting with left-side pleural effusion and signs of systemic venous congestion for 2 months. Echocardiography and computerized tomography showed a thickened pericardium and a mass in the right atrium. Pericardiectomy and excision of the right atrial mass were performed. Pathologic examination of the pericardium and the right atrial mass both revealed chronic granulomatous inflammation with acid-fast bacilli and confirmed the diagnosis of tuberculous constrictive pericarditis and right atrial tuberculoma. This case reminds us of the possibility of this type of rare combination of tuberculous constrictive pericarditis and intracardiac right atrial tuberculoma, and the need for complete imaging studies when such cases are encountered.
结核性缩窄性心包炎是一种罕见疾病,死亡率很高。缩窄性心包炎与心内结核瘤并存的情况此前未见报道。我们报告一例65岁男性,出现左侧胸腔积液和体循环静脉淤血体征达2个月。超声心动图和计算机断层扫描显示心包增厚及右心房有一肿块。进行了心包切除术及右心房肿块切除术。心包和右心房肿块的病理检查均显示慢性肉芽肿性炎症伴抗酸杆菌,确诊为结核性缩窄性心包炎和右心房结核瘤。该病例提醒我们注意这种结核性缩窄性心包炎与心内右心房结核瘤罕见组合的可能性,以及遇到此类病例时进行完整影像学检查的必要性。