Cardiac Department, National University Heart Centre Singapore, Yong Loo Lin School of Medicine, National University of Singapore, 5 Lower Kent Ridge Rd, Singapore.
Singapore Med J. 2009 Oct;50(10):e342-5.
We report two rare cases of right ventricular lipomatous involvement, and discuss their contrasting diagnostic images and clinical manifestations. Case 1 is a 21-year-old Malay man who presented with recurrent syncope. Transthoracic echocardiography showed a homogeneous discrete mass attached to the right ventricular septum, occupying the right ventricular outflow tract. Cardiac magnetic resonance (MR) imaging showed features consistent with intracardiac lipoma, which was confirmed on histology, upon surgical resection. Case 2, a 73-year-old Caucasian woman, was found to have incidental lipomatous infiltration of the right ventricle on echocardiography and MR imaging. In contrast to the well-defined right ventricular lipoma seen in the first case, lipomatous involvement was manifested as a diffuse homogeneous thickening of the right ventricular free wall. Multimodality imaging allows for a complementary and detailed characterisation of lipomatous masses involving the ventricular septum.
我们报告了两例罕见的右心室脂肪瘤浸润病例，并讨论了它们在影像学诊断和临床表现方面的差异。病例 1 是一名 21 岁的马来裔男性，反复出现晕厥。经胸超声心动图显示，一个均匀的离散肿块附着在右室间隔上，占据右心室流出道。心脏磁共振成像（MR）显示与心内脂肪瘤一致的特征，经手术切除后，组织学证实了这一点。病例 2 是一名 73 岁的白人女性，在超声心动图和 MR 成像上发现右心室有偶发的脂肪浸润。与第一个病例中清晰可见的右心室脂肪瘤不同，脂肪浸润表现为右心室游离壁的弥漫性均匀增厚。多模态成像可对累及室间隔的脂肪瘤进行互补和详细的特征描述。
