Edoute Y, Malberger E, Kuten A, Moscovitcz M, Ben-Haim S A
Department of Internal Medicine, Rambam Medical Center, Haifa, Israel.
J Surg Oncol. 1990 Oct;45(2):121-3. doi: 10.1002/jso.2930450212.
During the years 1975-1988, twenty lung cancer patients with symptomatic pericardial effusion were treated conservatively at our center. Echocardiography demonstrated small pericardial effusion in 2 patients, medium size effusion in 3 patients and large amount of fluid in 15 patients. Fifteen patients developed cardiac tamponade; in three of these patients, this was the presenting manifestation of lung cancer. Pericardiocentesis resulted in prompt, though temporary, symptomatic relief in all patients. Fluid cytology demonstrated suspected malignant cells in 2 patients and malignant cells in 13 patients. Based on cytology, the diagnosis of adenocarcinoma was established in six patients, small cell carcinoma in three patients, and epidermoid carcinoma in one patient. All patients were dead within 9 months from the time of diagnosis of pericardial effusion; 17 died within less than 3 months. It is concluded that pericardial effusion in lung cancer is indicative of rapid tumor progression and short survival. Fluid cytology provides an immediate and accurate means of diagnosis.
在1975年至1988年期间，我们中心对20例有症状性心包积液的肺癌患者进行了保守治疗。超声心动图显示，2例患者有心包少量积液，3例患者有中等量积液，15例患者有大量积液。15例患者发生了心脏压塞；其中3例患者，心脏压塞是肺癌的首发表现。心包穿刺术使所有患者的症状迅速得到缓解，尽管是暂时的。积液细胞学检查显示，2例患者有可疑恶性细胞，13例患者有恶性细胞。根据细胞学检查结果，6例患者确诊为腺癌，3例患者为小细胞癌，1例患者为表皮样癌。所有患者在诊断心包积液后9个月内死亡；17例患者在不到3个月内死亡。结论是，肺癌患者的心包积液表明肿瘤进展迅速且生存期短。积液细胞学检查提供了一种即时且准确的诊断方法。
