Sugiyama K, Naito T, Habu H, Kanamasa K, Sakaguchi Y, Ikawa H, Saito M, Inoue S, Nishioka T, Suzuki T
First Department of Internal Medicine, Kinki University School of Medicine, Osaka.
J Cardiol Suppl. 1992;28:67-75; discussion 76.
A 42-year-old man with cardiac lipoma of the anterior tricuspid leaflet is reported. He had a chief complaint of epigastric discomfort, and a pansystolic murmur was heard at the left sternal border in the 4th intercostal space. Two-dimensional echocardiography disclosed a mobile high density stalkless mass having several areas of low density. Two-dimensional Doppler echocardiogram revealed a moderate degree of tricuspid regurgitation. These findings were more clearly visualized on transesophageal echocardiogram. MRI revealed a high signal intensity on the T1-weighted image and a high radiodensity surrounding the mass using a contrast medium of Gd-DTPA. A 2.0 x 1.3 x 0.8 cm hemispherical, lobulated and sessile yellow mass was excised by means of open heart surgery, and tricuspid valvuloplasty was performed. The mass was adipose tissue and was surrounded by fibrous tissue just under the lamina fibrosa. These findings were compatible with those of the preoperative examinations, although the preoperative diagnosis was not conclusive. This was our first case of cardiac lipoma in which the tricuspid valve was successfully excised.
报告了一名42岁患有三尖瓣前叶心脏脂肪瘤的男性患者。他的主要症状是上腹部不适，在第4肋间左胸骨缘可闻及全收缩期杂音。二维超声心动图显示一个活动的高密度无蒂肿块，有几个低密度区域。二维多普勒超声心动图显示中度三尖瓣反流。经食管超声心动图更清晰地显示了这些发现。MRI在T1加权图像上显示高信号强度，使用钆喷酸葡胺造影剂时肿块周围显示高放射密度。通过心脏直视手术切除了一个2.0×1.3×0.8 cm的半球形、分叶状、无柄的黄色肿块，并进行了三尖瓣瓣膜成形术。肿块为脂肪组织，在纤维层下方被纤维组织包围。这些发现与术前检查结果相符，尽管术前诊断并不明确。这是我们第一例成功切除三尖瓣的心脏脂肪瘤病例。
