Stiru Ovidiu, Dragulescu Razvan, Geana Roxana Carmen, Chibulcutean Andreea, Raducu Laura, Tulin Adrian, Stroescu Andra Balcangiu, Diaconu Camelia, Savu Cornel, Bacalbasa Nicolae, Balescu Irina, Iliescu Vlad Anton
Department of Cardiovascular Surgery, 'Prof. Dr. C. C.' Iliescu Emergency Institute for Cardiovascular Diseases, 022322 Bucharest, Romania.
Department of Cardiovascular Surgery, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania.
Exp Ther Med. 2021 Jun;21(6):603. doi: 10.3892/etm.2021.10035. Epub 2021 Apr 14.
Despite the development of imagistic methods, the differential diagnosis of a right atrial mass may be difficult to be established, the most common pathologies which should be taken in consideration being represented by thrombus, tumors, prominent crista terminalis, or vegetation of infectious endocarditis. In this study, we present the case of a 63-year-old man with chronic kidney disease, in hemodialysis (HD) with a silicone central venous catheter (CVC) with the incidental transthoracic echocardiography (transthoracic echocardiogram, TTE) finding of a tumoral mass of 35x26 mm in the right atrium (RA), not related with the catheter, which was diagnosed as right atrial myxoma and underwent surgical excision. After reviewing the histopathology probe, the diagnosis of right atrial thrombus was confirmed. In conclusion, differentiating intracardiac right atrial masses (RAMs) could may prove challenging. In our patient, clinical presentation and the preoperative investigations could not differentiate the right atrial thrombus from a myxoma, and only the postoperative histopathology diagnosis was able to guide correct diagnosis.
尽管有影像学方法的发展，但右心房肿块的鉴别诊断可能仍难以确立，需要考虑的最常见病理情况包括血栓、肿瘤、显著的界嵴或感染性心内膜炎的赘生物。在本研究中，我们报告了一例63岁患有慢性肾脏病且正在接受血液透析（HD）的男性病例，其使用硅胶中心静脉导管（CVC），经胸超声心动图（经胸超声心动图，TTE）偶然发现右心房（RA）有一个35×26mm的肿瘤性肿块，与导管无关，该肿块被诊断为右心房黏液瘤并接受了手术切除。在复查组织病理学检查后，右心房血栓的诊断得到证实。总之，鉴别心内右心房肿块（RAMs）可能具有挑战性。在我们的患者中，临床表现和术前检查无法区分右心房血栓和黏液瘤，只有术后组织病理学诊断能够指导正确诊断。
