Kitazawa Sohei, Kitazawa Riko, Kondo Takeshi, Mori Kiyoshi, Matsui Toshimitsu, Watanabe Hiroshi, Watanabe Makoto
Division of Diagnostic Molecular Pathology, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan.
Cases J. 2009 Nov 27;2:9095. doi: 10.1186/1757-1626-2-9095.
We report a rare case of fatal cardiac tamponade attributed to coronary sinus thrombosis. An 83-year-old man was admitted to the hospital complaining of general fatigue. Laboratory examination revealed marked increase of atypical lymphoblastic cells in peripheral blood. CHOP therapy was started under the diagnosis of acute lymphoblastic leukemia. The patient died, however, of sudden cardiac arrest in the initial course of the chemotherapy. Autopsy revealed cardiac tamponade with markedly dilated and congested coronary vein induced by coronary sinus thrombosis. A condition similar to leukemia-related venous thromboembolic disease, combined with endothelial damage induced by leukemic infiltration, may cause this rare complication.
我们报告一例罕见的因冠状窦血栓形成导致的致命性心脏压塞病例。一名83岁男性因全身乏力入院。实验室检查显示外周血中非典型淋巴细胞显著增多。在诊断为急性淋巴细胞白血病后开始了CHOP治疗。然而，患者在化疗初期因心脏骤停死亡。尸检发现心脏压塞是由冠状窦血栓形成导致冠状静脉显著扩张和充血引起的。一种类似于白血病相关静脉血栓栓塞性疾病的情况，再加上白血病浸润引起的内皮损伤，可能导致这种罕见的并发症。
