Mellwig K P, Schmidt H, Gleichmann U, Raute-Kreinsen U
Kardiologische Klinik, Herzzentrum Nordrhein-Westfalen, Klinikum der Ruhr-Universität Bochum.
Dtsch Med Wochenschr. 1991 Oct 4;116(40):1505-8. doi: 10.1055/s-2008-1063780.
The chest roentgenogram in a 46-year-old woman with dyspnoea for several months revealed global cardiac enlargement. Echocardiography demonstrated a tumour in the right atrium, about 4 x 5 cm, as well as circular pericardial effusion. Septic temperatures occurred in the further course, and blood cultures grew Staphylococcus aureus. Recurrent pulmonary emboli and cerebral emboli with hemiparesis, especially of the brachiofacial region, occurred despite heparinization. Shortly after hospitalization a chest roentgenogram revealed a round shadow, about 1 cm in diameter, in the left upper lobe. The patient died in cardiogenic shock on the 16th hospital day. Autopsy showed the tumour to be a poorly differentiated round-cell sarcoma, originating from the wall of the right atrium, infiltrating the myocardium through to the epicardium and extending to the tricuspid orifice. The foramen ovale was open, making paradoxical emboli at atrial level possible.
一名46岁有数月呼吸困难症状的女性，其胸部X线片显示全心扩大。超声心动图显示右心房有一个约4×5厘米的肿瘤，以及环形心包积液。在病程后期出现败血症热，血培养培养出金黄色葡萄球菌。尽管进行了肝素化治疗，但仍反复发生肺栓塞和脑栓塞并伴有偏瘫，尤其是臂面部区域。住院后不久，胸部X线片显示左上叶有一个直径约1厘米的圆形阴影。患者在住院第16天死于心源性休克。尸检显示肿瘤为低分化圆形细胞肉瘤，起源于右心房壁，浸润心肌直至心外膜，并延伸至三尖瓣口。卵圆孔未闭，使得心房水平的反常栓塞成为可能。
