Ichikawa Seiji, Murakami Fumihiko, Ogiwara Hiroaki
Department of Thoracic and Cardiovascular Surgery, Meijo Hospital, Nagoya, Japan.
Kyobu Geka. 2018 Feb;71(2):135-137.
A 69-year-old male was referred to our hospital after being diagnosed as having pericarditis with pericardial effusion. The symptoms of tamponade disappeared after the effusion was drained;although the cause of pericarditis remained unidentified. About 4 months later, the tamponade symptoms recurred due to the thickened nodular pericardium. Partial pericardiectomy was performed, however the patient died on the 52nd day after surgery. Immunohistological examination with calretinin led to the diagnosis of primary malignant pericardial mesothelioma, which was an extremely rare pathology. Because the hyaluronic acid content of the effusion has been reported as a diagnostic aid for malignant mesothelioma, routine examination of the hyaluronic acid content for pericarditis with pericardial effusion may be necessary for early diagnosis and to improve prognosis.
一名69岁男性在被诊断为心包炎伴心包积液后转诊至我院。心包积液引流后心包填塞症状消失;尽管心包炎的病因仍不明。约4个月后,由于增厚的结节状心包,心包填塞症状复发。进行了部分心包切除术,但患者在术后第52天死亡。钙视网膜蛋白免疫组织学检查确诊为原发性恶性心包间皮瘤,这是一种极其罕见的病理类型。由于已有报道称积液中的透明质酸含量有助于诊断恶性间皮瘤,因此对于心包炎伴心包积液患者,常规检测积液中的透明质酸含量可能有助于早期诊断并改善预后。