Haskell R J, French W J
Chest. 1985 Jul;88(1):70-3. doi: 10.1378/chest.88.1.70.
Although neoplastic involvement of the pericardium frequently is present postmortem, cardiac manifestations before death are uncommon, and cardiac tamponade as the initial presentation of cancer is rare. In this study, a malignancy was first recognized in eight of 23 patients (35 percent) who presented with cardiac tamponade. Seven of these eight patients had lung and one patient thyroid carcinoma. The prognosis of these eight patients was poor with seven of eight patients dead within a mean of seven weeks (range 2.5 to 16). Overall, pericardial fluid cytology demonstrated a specific diagnosis of malignancy in 14 of 19 patients (74 percent). Earlier recognition of the possibility of malignancy may allow initiation of appropriate local or systemic treatment to lessen the probability of cardiac tamponade and improve survival. We recommend that all patients who present with tamponade have cytology performed on the pericardial fluid, even if malignancy is not suspected initially.
虽然心包肿瘤累及在尸检时经常出现，但生前的心脏表现并不常见，而以心脏压塞作为癌症的首发表现则很罕见。在本研究中，23例以心脏压塞就诊的患者中有8例（35%）最初被诊断为恶性肿瘤。这8例患者中7例患有肺癌，1例患有甲状腺癌。这8例患者的预后较差，8例中有7例在平均7周内（范围2.5至16周）死亡。总体而言，心包液细胞学检查在19例患者中的14例（74%）明确诊断为恶性肿瘤。更早认识到恶性肿瘤的可能性可能会促使开始适当的局部或全身治疗，以降低心脏压塞的可能性并提高生存率。我们建议，所有出现心脏压塞的患者都应进行心包液细胞学检查，即使最初不怀疑有恶性肿瘤。
