Department of Respiratory Medicine, Location Academic Medical Center (AMC), Amsterdam University Medical Centers, Amsterdam, The Netherlands.
Department of Respiratory Medicine, Medisch Centrum Leeuwarden, Leeuwarden, The Netherlands.
Respiration. 2021;100(9):918-922. doi: 10.1159/000516504. Epub 2021 Jun 24.
Primary cardiac tumors are extremely rare. Obtaining a tissue diagnosis is difficult and commonly requires open-heart surgery with associated morbidity. Esophageal endoscopic ultrasound (EUS) and EUS with the EBUS scope (EUS-B) provide real-time sampling of centrally located lung tumors and mediastinal lymph nodes. They also provide an excellent view of the left atrium, since it is located adjacent to the esophagus. To date, left atrium tumor diagnostics by endosonography is poorly explored. We describe 2 exceptional diagnostic cases of left atrium tumors in which cardiac surgery was hazardous due to the clinical condition or previous surgical interventions. During EUS-B-guided fine-needle aspiration (FNA), the left atrial masses were successfully and safely sampled, revealing a Burkitt lymphoma and a synovial sarcoma. FNA including cell block analysis enabled specific tumor diagnosis and molecular subtyping. Our findings suggest that in selected cases, linear endosonography qualifies as a minimally invasive technique for intracardiac tumor diagnostics.
原发性心脏肿瘤极为罕见。获取组织诊断较为困难，通常需要进行开胸手术，这会带来相关的发病率。食管内镜超声（EUS）和带有 EBUS 探头的 EUS（EUS-B）可实时对位于中央的肺部肿瘤和纵隔淋巴结进行取样。EUS-B 还可提供左心房的极佳视野，因为左心房紧邻食管。迄今为止，通过内镜超声检查对左心房肿瘤进行诊断的研究还很少。我们描述了 2 例特殊的左心房肿瘤诊断病例，由于临床状况或先前的手术干预，心脏手术存在风险。在 EUS-B 引导下的细针抽吸（FNA）过程中，成功、安全地对左心房肿块进行了取样，结果显示为 Burkitt 淋巴瘤和滑膜肉瘤。FNA 包括细胞块分析，可实现对特定肿瘤的诊断和分子亚型分类。我们的研究结果表明，在某些特定情况下，线性内镜超声检查可作为一种微创技术，用于心脏内肿瘤的诊断。
