Sharma Rajat, Golian Mehrdad, Shah Pallav, Jassal Davinder S, Shaikh Nasir
Section of Cardiology, Department of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, Rm Y3531, Bergen Cardiac Care Centre, St. Boniface Hospital, University of Manitoba, 409 Tache Avenue, Winnipeg, Manitoba, Canada, R2H 2A6.
Section of Cardiac Surgery, Department of Surgery, Max Rady College of Medicine, Rady Faculty of Health Sciences, Rm Y3531, Bergen Cardiac Care Centre, St. Boniface Hospital, University of Manitoba, 409 Tache Avenue, Winnipeg, Manitoba, Canada, R2H 2A6.
BMC Res Notes. 2017 Jan 7;10(1):25. doi: 10.1186/s13104-016-2323-9.
In the setting of an acute myocardial infarction (AMI), although the most common etiology of a left ventricular (LV) mass identified on multimodality cardiovascular imaging is a thrombus, other possibilities including a vegetation or tumor should be entertained within the differential diagnosis.
We describe a case of a 43-year-old Caucasian female post AMI diagnosed with a mid-cavitary mass within the LV. Although echocardiography and cardiovascular MRI (CMR) suggested that the mass was a thrombus, given the context of the recent AMI, exploration and surgical excision was completed by the surgeon due to the potential for the mass to embolize.
The final diagnosis of a papillary fibroelastoma was unique due to its unusual location and large size within the LV cavity. This unique case demonstrates shortcomings of multimodality cardiac imaging in the diagnosis of an atypical mass and the importance of obtaining tissue when clinically safe and feasible.
在急性心肌梗死(AMI)的情况下,尽管多模态心血管成像发现的左心室(LV)肿块最常见的病因是血栓,但鉴别诊断中应考虑其他可能性,包括赘生物或肿瘤。
我们描述了一例43岁的白种女性,急性心肌梗死后被诊断出左心室腔内有一个中腔肿块。尽管超声心动图和心血管磁共振成像(CMR)提示该肿块为血栓,但鉴于近期急性心肌梗死的情况,由于肿块有栓塞的可能性,外科医生进行了探查并完成了手术切除。
乳头状纤维弹性瘤的最终诊断因其在左心室腔内不寻常的位置和较大的尺寸而独特。这个独特的病例展示了多模态心脏成像在诊断非典型肿块方面的不足,以及在临床安全可行时获取组织的重要性。