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心房黏液瘤可模拟贝切特综合征患者的心内血栓:附组织病理学证实的病例研究。

Atrial myxoma as a mimicker of intracardiac thrombus in Behçet's syndrome: a case study with histopathological confirmation.

机构信息

Department of Internal Medicine, Istanbul University-Cerrahpasa, Cerrahpasa Medical Faculty, Istanbul, Turkey.

Department of Pathology, Istanbul University-Cerrahpasa, Cerrahpasa Medical Faculty, Istanbul, Turkey.

出版信息

Clin Exp Rheumatol. 2024 Oct;42(10):2092-2095. doi: 10.55563/clinexprheumatol/j29rnr. Epub 2024 Jul 15.

Abstract

Cardiomyopathies cause most intracardiac thrombosis (ICT), and Behçet's syndrome (BS) is a rare inflammatory disease that can be responsible for a proportion of ICT. Other inflammatory disorders involved in the aetiology of ICT include antiphospholipid syndrome, Henoch-Schonlein purpura, COVID-19, and Loeffler endocarditis. ICT usually occur during the active phase of BS, and they have a close relationship with vascular involvement. Atrial myxomas are benign cardiac tumours arising from the interatrial septum. They can lead to a substantial acute phase response, making them difficult to distinguish from inflammatory diseases. In this case study, we present a 46-year-old female BS patient who presented with constitutional symptoms mimicking BS flare in a routine follow-up visit and was diagnosed with left atrial myxoma after administration of several lines of immunosuppressives. Then, she underwent surgical tumour excision, and a histopathological examination confirmed the diagnosis.In conclusion, atrial myxoma should be kept in mind first of all when suspecting ICT, and advanced imaging methods such as cardiac magnetic resonance imaging (MRI) should be used if necessary.

摘要

心肌病是导致大多数心内血栓形成(ICT)的原因,而贝赫切特综合征(BS)是一种罕见的炎症性疾病,可能导致一部分 ICT。其他与 ICT 病因相关的炎症性疾病包括抗磷脂综合征、过敏性紫癜、COVID-19 和莱夫勒心内膜炎。ICT 通常发生在 BS 的活动期,与血管受累密切相关。心房黏液瘤是起源于心房间隔的良性心脏肿瘤。它们可引起明显的急性期反应,使其难以与炎症性疾病区分。在本病例研究中,我们介绍了一位 46 岁的女性 BS 患者,在常规随访就诊时出现类似于 BS 发作的全身症状,在给予数线免疫抑制剂治疗后被诊断为左心房黏液瘤。随后,她接受了手术肿瘤切除,组织病理学检查证实了诊断。总之,在怀疑 ICT 时,首先应考虑心房黏液瘤,如果需要,应使用心脏磁共振成像(MRI)等先进的影像学方法。

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