Murai Tadashi, Yonetsu Taishi, Isobe Mitsuaki, Kakuta Tsunekazu
Department of Cardiology, Tsuchiura Kyodo General Hospital, Japan.
Intern Med. 2016;55(24):3607-3609. doi: 10.2169/internalmedicine.55.7571. Epub 2016 Dec 15.
A 73-year-old man who had been transferred to our emergency room due to sudden chest pain was diagnosed with ST-segment elevation myocardial infarction (STEMI). Primary percutaneous coronary intervention was performed. A long, white object which looked like a parasitic worm was retrieved via intracoronary aspiration and revascularization was successfully completed. Contrast computed tomography revealed a huge 7×6 cm mass in the right upper pulmonary lobe with direct pulmonary vein invasion. Histopathologic examination of the aspirated coronary object revealed pleomorphic lung carcinoma. This is an unusual case of STEMI caused by lung tumor embolization via direct pulmonary vein invasion to the left side of the heart.
一名因突发胸痛被转送至我院急诊室的73岁男性被诊断为ST段抬高型心肌梗死（STEMI）。实施了急诊经皮冠状动脉介入治疗。通过冠状动脉内抽吸取出了一个看起来像寄生虫的白色长条物体，血管再通成功完成。对比增强计算机断层扫描显示右上肺叶有一个7×6 cm的巨大肿块，且肿块直接侵犯了肺静脉。对抽吸得到的冠状动脉内物体进行组织病理学检查，结果显示为多形性肺癌。这是一例由肺部肿瘤经肺静脉直接侵犯至心脏左侧导致肺肿瘤栓塞引起的STEMI罕见病例。
