Reddy Yogesh N V, Sundaram Varun, Stamler Jonathan S
Department of Internal Medicine, University Hospitals Case Medical Center, Cleveland, Ohio, USA.
BMJ Case Rep. 2013 Sep 26;2013:bcr2013200150. doi: 10.1136/bcr-2013-200150.
A previously healthy woman in her early 20s presented in week 38 of pregnancy with a 2-week history of haemoptysis, positional dyspnoea and an examination suggestive of pulmonary oedema. A chest CT showed a left lower lobe lung mass invading through the inferior pulmonary vein into the left atrium and abutting the posterior mitral leaflet. Pulmonary oedema consequent on left inferior pulmonary vein occlusion was initially restricted to the left lower lobe, but progressed to involve the contralateral lung following extension of the mass to the mitral orifice, resulting in functional mitral stenosis. A biopsy was positive for poorly differentiated spindle cell neoplasm. This is the first reported case of a pregnant patient with spindle cell neoplasm of lung and of a spindle neoplasm causing mitral stenosis, as well as the youngest known case of this disease.
一名20岁出头既往健康的女性在妊娠38周时出现咯血、体位性呼吸困难2周，检查提示肺水肿。胸部CT显示左肺下叶肿块，经下肺静脉侵入左心房，紧邻二尖瓣后叶。左下肺静脉闭塞导致的肺水肿最初局限于左肺下叶，但随着肿块延伸至二尖瓣口，进展至累及对侧肺，导致功能性二尖瓣狭窄。活检结果为低分化梭形细胞瘤阳性。这是首例报道的妊娠合并肺梭形细胞瘤患者，也是首例梭形细胞瘤导致二尖瓣狭窄的病例，同时也是该疾病已知最年轻的病例。
