Chaara A, Abdelali S, el Haitem N, Berrada A, Benomar M
Centre national de cardiologie, hôpital Avicenne, Maroc.
Arch Mal Coeur Vaiss. 1988 Dec;81(12):1547-50.
In reporting a case of haemangiosarcoma of the right atrium the authors emphasize the problems encountered in the diagnosis of primary tumours of the heart. The patient was a 50-year old woman who complained of digestive disorders and palpitations. Physical examination showed signs of right heart failure associated with a systolic murmur on the right side of the sternum. ECG gave normal results. Echocardiography displayed a pouch with liquid ultrastructure communicating with the right atrium. Angiography confirmed the presence of a cavity with irregular borders communicating with the right atrium. Coronary arteriography showed an abnormal disorderly distribution of the right coronary artery branches with newly formed vessels extending toward the tumour. At exploratory thoracotomy a large liquid tumour was found which bled at the slightest touch and was attached to the mediastinum and the right pericardium. The pleura and the lung contained several nodules of the same venous colour as the mother tumour. Extemporaneous biopsy and pathological analysis were in favour of a haemangiosarcoma. The patient died a few days after the thoracotomy.
在报告一例右心房血管肉瘤病例时,作者强调了心脏原发性肿瘤诊断中遇到的问题。患者为一名50岁女性,主诉消化紊乱和心悸。体格检查显示有右心衰竭体征,胸骨右侧有收缩期杂音。心电图结果正常。超声心动图显示一个具有液体超微结构的囊袋与右心房相通。血管造影证实存在一个边界不规则且与右心房相通的腔。冠状动脉造影显示右冠状动脉分支分布异常且紊乱,有新生血管向肿瘤延伸。在开胸探查时,发现一个大的液性肿瘤,稍有触碰就会出血,且与纵隔和右心包相连。胸膜和肺中有几个与母瘤颜色相同的静脉样结节。术中活检及病理分析支持血管肉瘤的诊断。患者在开胸手术后几天死亡。