Fraser R S, Viloria J B, Wang N S
Cancer. 1980 Apr 1;45(7):1697-1704. doi: 10.1002/1097-0142(19800401)45:7<1697::aid-cncr2820450730>3.0.co;2-j.
Three cases of adenocarcinoma of the lung manifesting as acute pericardial effusion with tamponade are presented and the medical literature concerning this unusual manifestation of extracardiac malignancy is reviewed. We have found 22 cases of carcinoma and 4 cases of sarcoma. Of the carcinomas, 14 of 19 (74%) with known primary are pulmonary and 13 of 18 (72%) with tissue diagnosis are adenocarcinomas. Daignosis was made by cytologic examination of pericardial fluid in 14 of 16 cases (87%) in which it was performed. The lymphatic drainage of the heart renders some anatomical explanations for the prevalence of carcinoma of the lung as the cause of cardiac tamponade and the discrepancy of finding tumor cells in the pericardial fluid but not in the pericardium. Patients treated with pericardiectomy with or without ancillary radio- or chemotherapy survived longer than those treated with periocardiocentesis or radio- or chemotherapy alone.
本文报告了3例表现为急性心包积液伴心脏压塞的肺腺癌病例，并对有关心外恶性肿瘤这种不寻常表现的医学文献进行了综述。我们发现了22例癌和4例肉瘤。在这些癌中，已知原发灶的19例中有14例（74%）为肺部原发，经组织学诊断的18例中有13例（72%）为腺癌。在进行心包积液细胞学检查的16例病例中，有14例（87%）通过该检查做出了诊断。心脏的淋巴引流为肺癌作为心脏压塞原因的普遍性以及在心包积液中而非心包中发现肿瘤细胞的差异提供了一些解剖学解释。接受心包切除术联合或不联合辅助放疗或化疗的患者比仅接受心包穿刺术或放疗或化疗的患者存活时间更长。
