Htwe Khaing Khaing, Aung Thein T
Internal Medicine, Kingsbrook Jewish Medical Center, Brooklyn, USA.
Cardiology, Miami Valley Hospital, Wright State University, Dayton, USA.
Cureus. 2020 Jun 14;12(6):e8620. doi: 10.7759/cureus.8620.
A 61-year-old female former smoker with history of bronchial-associated lymphoid tissue lymphoma presented with increasing dyspnea, cough with white phlegm and significant weight loss. Chest X-ray showed complete opacification of the left hemithorax. A computed tomography (CT) pulmonary angiogram ruled out pulmonary embolism but revealed mass within the left atrium. A transthoracic echocardiography showed an echogenic mass in the left atrium. A cardiac MRI confirmed a bulky left lung mass suggestive of carcinoma invading the left atrium via the left pulmonary veins. CT-guided biopsy of left lung mass was suggestive of non-small cell lung carcinoma (NSCLC, adenocarcinoma). We would like to discuss the challenges and the importance of making the correct diagnosis of intracardiac mass.
一名61岁有支气管相关淋巴组织淋巴瘤病史的女性戒烟者，出现进行性呼吸困难、咳白痰及显著体重减轻。胸部X线显示左半胸完全致密影。计算机断层扫描（CT）肺动脉造影排除了肺栓塞，但显示左心房内有肿块。经胸超声心动图显示左心房内有一强回声肿块。心脏磁共振成像证实左肺有一巨大肿块，提示癌肿经左肺静脉侵犯左心房。左肺肿块的CT引导下活检提示为非小细胞肺癌（NSCLC，腺癌）。我们想讨论诊断心内肿块时面临的挑战以及做出正确诊断的重要性。
