Pinto M M
Acta Cytol. 1986 Nov-Dec;30(6):657-61.
Cardiac tamponade due to malignant effusion, though rarely the initial manifestation of malignancy, is usually secondary to adenocarcinoma of the lung. Two cases are reported. One patient presented with cardiac tamponade; the other had diffuse cutaneous involvement of the left neck and shoulder two months before he presented with cardiac tamponade. Cytologic examination of both fluids revealed adenocarcinoma. Ultrastructural examination showed poorly differentiated adenocarcinoma in the first patient and bronchioloalveolar carcinoma in the second; carcinoembryonic antigen levels in the fluids were 9.4 ng/mL and over 60 ng/mL, respectively. The computed tomographic (CT) scans of both patients revealed mediastinal fullness with no lung involvement. Even in the absence of a pulmonary mass, lung carcinoma may be the likely primary in patients with malignant pericardial effusions.
恶性积液导致的心脏压塞虽然很少是恶性肿瘤的初始表现，但通常继发于肺癌。本文报告两例。一例患者以心脏压塞为首发症状；另一例在出现心脏压塞前两个月有左颈部和肩部皮肤弥漫性受累。对两种积液进行的细胞学检查均发现腺癌。超微结构检查显示，第一例患者为低分化腺癌，第二例为细支气管肺泡癌；两种积液中的癌胚抗原水平分别为9.4 ng/mL和超过60 ng/mL。两名患者的计算机断层扫描（CT）均显示纵隔饱满，无肺部受累。即使没有肺部肿块，恶性心包积液患者的原发性肿瘤也可能是肺癌。
