Ichiba T, Kamihira S, Namba T, Kuroda H, Hara Y, Ohgi S, Horie Y
Department of Cardiovascular Surgery, Tuyama Daiichi Hospital, Tuyama, Japan.
J Cardiovasc Surg (Torino). 2001 Aug;42(4):485-8.
Blood cysts of the heart are extremely rare in adults and usually involve valves or the left ventricle. Although two cases of blood cysts in the right atrium in adults have been reported, a cyst combined with a disorder of the valves has never been reported. We report a 52-year-old woman with a blood cyst that generated from the right atrial septum. Furthermore, the patient had regurgitation of both the mitral and tricuspid valves and then underwent surgical excision of the blood cyst, mitral valve plasty and tricuspid valve annuloplasty. We believe that it is possible to diagnose blood cysts with echocardiography, CT and magnetic resonance imaging. Echocardiography showed the cyst as a circle without a complete inner free-echo. CT and magnetic resonance imaging showed a mass with a non-enhanced inner structure. Furthermore, the latter showed a cyst that was enhanced by T1- but not T2-weighted images, indicating that the content of the cyst was a persistent substance such as blood. Concerning the generation of blood cysts, we hypothesize that heteroplastic growth arising from primitive pericardial mesothelium causes disorders of valves and blood cysts.
心脏血囊肿在成人中极为罕见，通常累及瓣膜或左心室。尽管已有两例成人右心房血囊肿的报道，但囊肿合并瓣膜病变的情况从未有过报道。我们报告一例52岁女性，其血囊肿起源于右心房间隔。此外，该患者存在二尖瓣和三尖瓣反流，随后接受了血囊肿手术切除、二尖瓣成形术和三尖瓣瓣环成形术。我们认为，通过超声心动图、CT和磁共振成像有可能诊断出血囊肿。超声心动图显示囊肿为圆形，内部无完整的自由回声。CT和磁共振成像显示肿块内部结构无强化。此外，磁共振成像显示囊肿在T1加权图像上有强化而在T2加权图像上无强化，表明囊肿内容物为血液等持久性物质。关于血囊肿的形成，我们推测原始心包间皮的异质性生长会导致瓣膜病变和血囊肿。
