Ishiwata T, Milanga M, Urata S, Yokoyama M, Asano G
Department of Pathology, Nippon Medical School.
Kokyu To Junkan. 1991 Apr;39(4):395-8.
A 63-year-old male complained of palpitation and dyspnea. ECG showed paroxysmal supraventricular tachycardia. Echocardiogram revealed asymmetrical thickening of the cardiac septum, and by other clinico-pathological observations, nephrotic syndrome and colon adenoma were detected. For these diseases, steroid therapy and operation were performed, respectively. Ten months later, chest X-ray revealed diffuse abnormal shadow in the bilateral lung fields, and the patient expired due to respiratory distress syndrome. The patient's heart weighted 300g and showed extensive myofibril disarray in bilateral ventricles involving the septal region of the heart. Degeneration and atrophy of the atrioventricular node was seen. In the lungs, organizing pneumonia, old pleuritis, diffuse septal fibrosis and cytomegalovirus infection were demonstrated in the alveolar walls. Kidneys showed slightly sclelotic changes in glomeruli and edema-fibrosis in the interstitium. In this rare case, hypertrophic cardiomyopathy was combined with nephrotic syndrome due to glomerular change, and colon adenoma. The patient died of cytomegalovirus infection in the lungs. The histogenesis of myofibril disarray was discussed in these diseases.
一名63岁男性主诉心悸和呼吸困难。心电图显示阵发性室上性心动过速。超声心动图显示心脏间隔不对称增厚,通过其他临床病理观察,发现了肾病综合征和结肠腺瘤。针对这些疾病,分别进行了类固醇治疗和手术。十个月后,胸部X线显示双侧肺野弥漫性异常阴影,患者因呼吸窘迫综合征死亡。患者心脏重300克,双侧心室包括心脏间隔区域出现广泛的肌原纤维紊乱。可见房室结变性和萎缩。肺部,肺泡壁出现机化性肺炎、陈旧性胸膜炎、弥漫性间隔纤维化和巨细胞病毒感染。肾脏显示肾小球轻度硬化改变和间质水肿纤维化。在这个罕见病例中,肥厚型心肌病与因肾小球改变导致的肾病综合征以及结肠腺瘤合并存在。患者死于肺部巨细胞病毒感染。对这些疾病中肌原纤维紊乱的组织发生进行了讨论。