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病例报告:一名接受血液透析的患者右心房出现原发性钙化心脏肿物,部分阻塞三尖瓣。

Case report: A primary calcified cardiac mass in right atrium partially obstructs the tricuspid valve in a patient on hemodialysis.

作者信息

Liu Hongduan, Tu Xiaokang, Zhang Hao, Fan Chengming, Tan Haoyu, Song Long, Wu Qin, Liu Liming

机构信息

Department of Cardiovascular Surgery, The Second Xiangya Hospital, Central South University, Changsha, China.

出版信息

Front Cardiovasc Med. 2022 Aug 16;9:950628. doi: 10.3389/fcvm.2022.950628. eCollection 2022.

Abstract

Primary cardiac calcification is a rare benign mass in patients with end-stage renal disease. A few cases have been reported in the literatures. In this case study, during a routine checkup for hemodialysis, a transthoracic echocardiography on a 19-year-old male showed a cardiac mass in the right atrium that was partially obstructing the tricuspid valve. Cardiac magnetic resonance imaging showed a well-circumscribed, homogeneous "shadow" in the right atrium; it measured 29 × 27 mm, had equal T1- and T2-weighted signal intensities, and was adjacent to the tricuspid valve. According to 18F-fluorodeoxyglucose positron emission tomography combined with computed tomography, there was a dense circular shadow in the right atrium abutting the tricuspid valve, but there was no increase in glucose metabolism. Median sternotomy was performed for the surgical resection of the mass, and a cardiopulmonary bypass was completed. The mass was completely removed. The patient recovered well and was discharged 10 days after the surgery. Histological examination showed that the mass contained multiple calcified nodules. No mass recurrence was found by echocardiography during the 12th-month follow-up.

摘要

原发性心脏钙化是终末期肾病患者中一种罕见的良性肿块。文献中已报道了少数病例。在本病例研究中,在一次血液透析常规检查期间,对一名19岁男性进行的经胸超声心动图检查显示右心房有一个心脏肿块,部分阻塞了三尖瓣。心脏磁共振成像显示右心房有一个边界清晰、均匀的“阴影”;其大小为29×27毫米,T1加权和T2加权信号强度相等,且与三尖瓣相邻。根据18F-氟脱氧葡萄糖正电子发射断层扫描结合计算机断层扫描,右心房有一个紧靠三尖瓣的致密圆形阴影,但葡萄糖代谢无增加。进行了正中胸骨切开术以手术切除肿块,并完成了体外循环。肿块被完全切除。患者恢复良好,术后10天出院。组织学检查显示肿块包含多个钙化结节。在第12个月的随访期间,超声心动图未发现肿块复发。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e1f5/9424608/274fc5a742ae/fcvm-09-950628-g0001.jpg

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