Nishikawa Y, Akaishi M, Handa S, Nakamura Y, Hori S, Ogata K, Hosoda Y
Department of Medicine, Keio University School of Medicine, Tokyo, Japan.
Cardiology. 1991;78(4):357-62. doi: 10.1159/000174817.
A patient with malignant lymphoma suddenly collapsed, and ST segment elevation with complete atrioventricular block was observed on his electrocardiogram during an episode resembling acute myocardial infarction. Cardiac cineangiography revealed posterobasal asynergy of the left ventricle with no significant obstruction in the coronary arterial tree. Autopsy revealed diffuse invasion of the myocardium by lymphoma cells. Left ventricular wall motion was preserved even in the area of massive invasion; there was no true necrosis. Myocardial biopsy may be indicated in patients in whom there is a discrepancy between coronary pathoanatomy and wall motion abnormalities.
一名恶性淋巴瘤患者突然晕倒,在一次类似急性心肌梗死的发作期间,其心电图显示ST段抬高并伴有完全性房室传导阻滞。心脏电影血管造影显示左心室后基底段运动失调,冠状动脉树无明显阻塞。尸检显示淋巴瘤细胞弥漫性浸润心肌。即使在大量浸润区域,左心室壁运动仍得以保留;无真正的坏死。对于冠状动脉病理解剖与壁运动异常存在差异的患者,可能需要进行心肌活检。