Ogawa Y, Ohshima H, Kawashima E, Akita N, Tanazawa S, Tobise K, Onodera S, Aoki H, Kubota H, Murakami C
First Department of Internal Medicine, Asahikawa Medical College.
Kokyu To Junkan. 1991 Mar;39(3):283-6.
A 72-year-old woman had experienced palpitation and fatigue during exertion for two months and was referred to our hospital from her nearby hospital. On physical examination, a systolic murmur was heard in the left fourth intercostal space. A chest X-ray film showed cardiac enlargement (CTR 64%). An ECG showed elevated P waves in leads II, III. Transthoracic echocardiography revealed a large oval heterogeneous mass in the right atrium. Transesophageal echocardiography (TEE) revealed the right atrial mass clearly, which was attached to the atrial septum with a short wide stalk. This mass prolapsed from the right atrium into the right ventricle in diastole. And there were some cysts in the homogeneous high-echoic lesion. The chest CT and MRI also showed the mass in the right atrium. However, these images were not clear. Surgical excision of the mass was undertaken. A solid mass measuring 75 x 50 x 45 mm was attached to the fossa ovalis with a wide short stalk. There were several cysts in the mass. Pathological examination showed myxomatous tissue. In this case, TEE was the most valuable means for evaluation of the right atrial mass.
一名72岁女性在劳累时出现心悸和乏力症状达两个月，遂从附近医院转至我院。体格检查发现左第四肋间有收缩期杂音。胸部X线片显示心脏增大（心胸比率64%）。心电图显示II、III导联P波高尖。经胸超声心动图显示右心房有一个巨大椭圆形不均匀肿块。经食管超声心动图（TEE）清晰显示右心房肿块，其通过短而宽的蒂附着于房间隔。该肿块在舒张期从右心房脱垂至右心室。在均匀高回声病变中有一些囊肿。胸部CT和MRI也显示右心房有肿块。然而，这些图像并不清晰。遂对肿块进行手术切除。一个大小为75×50×45mm的实性肿块通过宽短蒂附着于卵圆窝。肿块内有多个囊肿。病理检查显示为黏液瘤组织。在这种情况下，TEE是评估右心房肿块最有价值的方法。
