一例罕见的巨大细胞肺癌经肺静脉向心腔内蔓延并形成血栓的病例。

A rare case of giant cell lung carcinoma with intracardiac extension via the pulmonary vein and thrombus formation.

作者信息

Leivaditis Vasileios, Koletsis Efstatios, Spiliotopoulos Konstantinos, Grapatsas Konstantinos, Tzelepi Vasiliki, Dougenis Dimitrios

机构信息

Department of Cardiothoracic and Vascular Surgery, Westpfalz-Klinikum, Kaiserslautern, Germany.

Department of Cardiothoracic Surgery, University Hospital of Patras, Patras, Greece.

出版信息

J Surg Case Rep. 2018 Jun 25;2018(6):rjy144. doi: 10.1093/jscr/rjy144. eCollection 2018 Jun.

DOI:10.1093/jscr/rjy144

PMID:29977517

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6016651/

Abstract

A 61-year-old man presented with dyspnea, left thoracic pain and productive cough. Chest computed tomography demonstrated a solid mass of the left upper lobe, 2.9 × 1.8 cm in size, which had irregular borders and appeared to infiltrate and totally occlude the upper left pulmonary vein extending up to the left atrium (LA) with thrombus formation. The patient underwent median sternotomy and left pneumonectomy, combined with LA thrombus resection under cardiopulmonary bypass (CPB) with bicaval cannulation. The LA was partially resected and the intracavitary thrombus was completely removed. The surgical margins were free of tumor cells. Episodes of embolism were not observed during surgery. The patient was successfully weaned from CPB. The postoperative course was uncomplicated. Pathological examination of the resected specimen revealed giant cell carcinoma.

摘要

一名61岁男性患者出现呼吸困难、左胸痛和咳痰。胸部计算机断层扫描显示左肺上叶有一个实性肿块，大小为2.9×1.8厘米，边界不规则，似乎浸润并完全阻塞了左上肺静脉，血栓形成一直延伸至左心房（LA）。患者接受了正中胸骨切开术和左肺切除术，并在体外循环（CPB）双腔插管下联合进行左心房血栓切除术。左心房部分切除，腔内血栓完全清除。手术切缘无肿瘤细胞。手术期间未观察到栓塞事件。患者成功脱离体外循环。术后过程无并发症。切除标本的病理检查显示为巨细胞癌。