Yalavarthy U, Agrawal V K, Showkat A
Division of Nephrology, University of Tennessee Health Science Center, Memphis, TN 38163, USA.
Clin Nephrol. 2011 Feb;75 Suppl 1:56-9.
A 53-year-old African-American female with end-stage renal disease presented with 3 months history of right breast swelling. The patient had a right internal jugular tunneled catheter for dialysis access. Physical examination was significant for right breast swelling, peau d'orange appearance, and mild tenderness on palpation. Mammogram was normal. A CT scan of the chest with contrast demonstrated chest wall edema and prominent superficial collateral veins suggesting central vein obstruction. Right upper extremity venogram revealed right innominate vein occlusion up to its junction with the subclavian vein. Angioplasty of occluded segment was attempted and was unsuccessful, but right breast swelling significantly improved following the procedure. Pathogenesis, clinical manifestations and management of central vein stenosis is discussed.
一名患有终末期肾病的53岁非裔美国女性，出现右乳肿胀3个月。该患者有一条用于透析通路的右颈内静脉隧道式导管。体格检查发现右乳肿胀、橘皮样外观，触诊时有轻度压痛。乳房X线摄影正常。胸部增强CT扫描显示胸壁水肿和明显的浅表侧支静脉，提示中心静脉阻塞。右上肢静脉造影显示右无名静脉直至其与锁骨下静脉交界处闭塞。尝试对闭塞段进行血管成形术但未成功，但术后右乳肿胀明显改善。本文讨论了中心静脉狭窄的发病机制、临床表现及治疗。
