Chaudhuri Krishna G, Revels Jonathan W, Yadwadkar Kaustubh S, Johnson Lester S
Department of Radiology, Eastern Virginia Medical School, PO Box 1980, Norfolk, VA 23507, USA.
Radiol Case Rep. 2017 Jun 10;12(3):449-454. doi: 10.1016/j.radcr.2017.04.023. eCollection 2017 Sep.
We present a case of an intensely hypermetabolic intracavitary cardiac mass, standardized uptake values max 44.4, that was pathologically proved to be organizing and organized thrombus, negative for tumor. Our patient had previous right atrial mass resection 2 years prior that was pathologically described as either thrombus or infarcted atrial myxoma. She had since been on lifelong controlled anticoagulation; and on routine follow-up imaging, she had recurrent slow growth of a new right atrial mass. During a later hospital admission for chest pain, the mass was evaluated on both transthoracic and transesophageal echo cardiogram, which could not differentiate thrombus vs neoplasm. Cardiac magnetic resonance imaging was equivocal for mass enhancement. The patient underwent fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) evaluation, which revealed intensely hypermetabolic activity within the mass concerning for malignancy, potentially an aggressive tumor. Subsequently, the mass was surgically excised for pathological diagnosis.
我们报告一例腔内心脏肿物，其代谢极度增高，最大标准化摄取值为44.4，病理证实为机化性及已机化血栓，肿瘤阴性。我们的患者两年前曾行右心房肿物切除术，病理描述为血栓或梗死性心房黏液瘤。此后她一直接受终身抗凝治疗；在常规随访影像检查中，她新出现的右心房肿物反复缓慢生长。在后来因胸痛住院期间，经胸和经食管超声心动图对该肿物进行了评估，但无法区分血栓与肿瘤。心脏磁共振成像对于肿物强化表现不明确。患者接受了氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（18F-FDG PET/CT）评估，结果显示肿物内代谢极度增高，提示恶性肿瘤，可能是侵袭性肿瘤。随后，该肿物被手术切除以进行病理诊断。
