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[胸腺区域创伤后快速发展肿瘤的疑难诊断。包裹性血肿还是囊内出血?]

[Difficult diagnosis of a rapidly developing post-traumatic tumor of the thymus region. Encysted hematoma or intracystic hemorrhage?].

作者信息

Vergnon J M, Cuilleret J, Fournel P, Gaubert J Y, Boucheron S, Vacherot J C, Emonot A

出版信息

Rev Pneumol Clin. 1986;42(4):199-203.

PMID:3787064
Abstract

We report a case of rapidly developing (subacute) post-traumatic mediastinal haematoma which initially suggested a malignant tumour of the thymus region. The lesion, discovered on the basis of non-specific signal symptoms 2 months after a mild chest injury, consisted of a voluminous tumour of the thymus region associated with pericardial effusion. At angiography, the mass proved to be extravascular. CT scans of the thorax showed that it surrounded, but did not compress, the mediastinal vessels. Surgery revealed an organized encysted haematoma of the thymus region that had ruptured into the pericardial cavity containing a blood collection. The possibility of an intracystic haemorrhage in a cystic tumour preexisting to the trauma is discussed, but a more likely diagnosis would be chronic haematoma, especially since a similar case independent of any injury has already been published.

摘要

我们报告一例创伤后迅速发展(亚急性)的纵隔血肿病例,该病例最初提示为胸腺区域的恶性肿瘤。该病变在轻度胸部损伤2个月后因非特异性信号症状而被发现,表现为胸腺区域的巨大肿瘤并伴有心包积液。血管造影显示,肿块为血管外病变。胸部CT扫描显示,它环绕但未压迫纵隔血管。手术发现胸腺区域有一个机化的包裹性血肿,已破裂进入心包腔并伴有积血。文中讨论了创伤前存在的囊性肿瘤内发生囊内出血的可能性,但更可能的诊断是慢性血肿,尤其是因为此前已经发表过一例与任何损伤无关的类似病例。

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