Jun-Yan Huang, Hai-Ping Jiang, Han-Lin Tang, Department of General Surgery, The First Affiliated Hospital of Jinan University, West No. 613, Huangpu Road, Guangzhou 510630, Guangdong Province, China.
World J Gastrointest Oncol. 2011 Apr 15;3(4):67-70. doi: 10.4251/wjgo.v3.i4.67.
Primary gastric signet ring cell carcinoma presenting as cardiac tamponade is difficult to diagnosis early. Patients are generally asymptomatic until the disease is advanced. General practitioners usually focus on the initial symptoms related to pericarditis and pericardial effusion. We report a case of signet-ring cell carcinoma of the stomach presenting as cardiac tamponade with pericarditis and pericardial effusion but without any gastrointestinal symptoms. A 49-year old woman was admitted because of progressive dyspnea and cough. Chest X-ray revealed an increased cardiothoracic ratio and a small amount of bilateral pleural effusion. Two dimensional ultrasonographic echocardiography pericardial effusions with atrial and right ventricular early diastolic collapse were found, establishing the diagnosis of cardiac tamponade. Pericardiocentesis was performed and 420 mL of bloody fluid was taken. The patient died of respiratory failure and cardiac arrest on October 28, 2009. Post-mortem examination revealed diffuse gastric mucosa erosion and edema with stomach mucosa incrassation in the greater curvature. The primary lesion was histopathologically diagnosed as signet-ring cell carcinoma of the stomach.
原发性胃印戒细胞癌表现为心脏压塞，早期诊断困难。患者通常在疾病晚期才出现症状。全科医生通常关注与心包炎和心包积液相关的初始症状。我们报告一例以心包炎和心包积液为表现的胃印戒细胞癌心脏压塞病例，但无任何胃肠道症状。一名 49 岁女性因进行性呼吸困难和咳嗽入院。胸部 X 线显示心胸比增加，双侧少量胸腔积液。二维超声心动图显示心包积液，心房和右心室早期舒张塌陷，诊断为心脏压塞。进行了心包穿刺，抽取了 420 毫升血性液体。患者于 2009 年 10 月 28 日死于呼吸衰竭和心脏骤停。尸检显示弥漫性胃黏膜糜烂和水肿，胃大弯黏膜增厚。原发性病变经组织病理学诊断为胃印戒细胞癌。
