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意料之外的情况：一名移植患者的右心房肿物

Expecting the unexpected: right atrial mass in a transplant patient.

作者信息

Yousefzai Rayan, Trivedi Setu, Jain Renuka, Cheema Omar M, Crouch John D, Thohan Vinay, Khandheria Bijoy K

机构信息

Aurora Cardiovascular Services Aurora Sinai/Aurora St. Luke's Medical Centers 2801 W. Kinnickinnic River Parkway, Ste. 840 Milwaukee WI 53215 USA.

出版信息

ESC Heart Fail. 2015 Dec;2(4):164-167. doi: 10.1002/ehf2.12065. Epub 2015 Nov 15.

DOI:10.1002/ehf2.12065
PMID:27774261
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5063103/
Abstract

We present a 71-year-old male, who had had a heart transplantation 24 years prior, who came to our clinic with a low-grade fever and a new II/VI holosystolic murmur. Echocardiography showed a large mass in the right atrium with attachment near the junction of the right atrium and superior vena cava. The patient was taken to the operating room for resection of the mass. Microscopic evaluation was consistent with thrombus. Differential diagnosis of cardiac masses after cardiac transplant includes tumour, thrombus, and vegetation. Final diagnosis can be challenging; multimodality imaging and biopsy or resection often are required for final diagnosis.

摘要

我们报告一名71岁男性，他在24年前接受了心脏移植，因低热和新出现的全收缩期II/VI级杂音前来我们诊所就诊。超声心动图显示右心房有一个大肿块，附着于右心房与上腔静脉交界处附近。患者被送往手术室切除肿块。显微镜评估结果与血栓一致。心脏移植后心脏肿块的鉴别诊断包括肿瘤、血栓和赘生物。最终诊断可能具有挑战性；通常需要多模态成像以及活检或切除才能做出最终诊断。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0ffd/5746974/213c91d55329/EHF2-2-164-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0ffd/5746974/a00180c531c7/EHF2-2-164-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0ffd/5746974/09cfe32129c1/EHF2-2-164-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0ffd/5746974/1503adc9c3b2/EHF2-2-164-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0ffd/5746974/700bd54e6c44/EHF2-2-164-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0ffd/5746974/8051489d8287/EHF2-2-164-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0ffd/5746974/213c91d55329/EHF2-2-164-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0ffd/5746974/a00180c531c7/EHF2-2-164-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0ffd/5746974/09cfe32129c1/EHF2-2-164-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0ffd/5746974/1503adc9c3b2/EHF2-2-164-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0ffd/5746974/700bd54e6c44/EHF2-2-164-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0ffd/5746974/8051489d8287/EHF2-2-164-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0ffd/5746974/213c91d55329/EHF2-2-164-g006.jpg

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本文引用的文献

1
Atrial masses post cardiac transplantation: diagnostic and treatment dilemmas.心脏移植术后心房肿块：诊断和治疗的困境。
Am J Transplant. 2012 Aug;12(8):2237-41. doi: 10.1111/j.1600-6143.2012.04129.x. Epub 2012 Jun 8.
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Cardiac tumours: diagnosis and management.心脏肿瘤：诊断与管理
Heart. 2011 Jan;97(2):151-60. doi: 10.1136/hrt.2009.186320.
3
Infective endocarditis following orthotopic heart transplantation: 10 cases and a review of the literature.原位心脏移植术后感染性心内膜炎：10例病例及文献综述
Transpl Infect Dis. 2004 Dec;6(4):165-70. doi: 10.1111/j.1399-3062.2004.00074.x.
4
Left atrial thrombus mistaken as a tumor after heart transplantation.
Thorac Cardiovasc Surg. 2003 Dec;51(6):347-50. doi: 10.1055/s-2003-45429.
5
Systemic embolism: a serious complication after cardiac transplantation avoidable by bicaval technique.
Eur J Cardiothorac Surg. 2001 Mar;19(3):307-11; discussion 311-2. doi: 10.1016/s1010-7940(00)00653-9.