Funck R, Achler C, Drude L, Leppek R, Hehrlein F W, Maisch B
Abteilung Innere Medizin--Kardiologie, Philipps-Universität, Marburg.
Herz. 1994 Jun;19(3):156-61.
We report the case of a 59-year old patient with the rare combination of silicosis and rheumatoid arthritis, which is called Caplan's syndrome. The patient presented with right heart failure caused by a pericardial tumor compressing the right and the left ventricle. By means of several imaging techniques it was possible to elucidate the topographic relations of the tumor. Definite signs of malignant growth were not found. Despite his elevated perioperative risk we decided to operate on the patient. During the operation macroscopic and histologic evidence revealed that the tumor was not a neoplastic process but consisted of an organized hemopericardium. This demonstrates that pericarditis in rheumatoid arthritis can be hemorrhagic and can mimick a malignant pericardial tumor. The decision to operate was first supported by the findings of the applied imaging techniques, the normal endomyocardial biopsy, and the clinical course and were later confirmed in situ.
我们报告了一例59岁患者，其患有矽肺和类风湿性关节炎的罕见组合，即卡普兰综合征。该患者因心包肿瘤压迫左右心室而出现右心衰竭。通过多种成像技术得以阐明肿瘤的地形关系。未发现恶性生长的确切迹象。尽管其围手术期风险较高，我们仍决定对该患者进行手术。手术过程中，宏观和组织学证据显示该肿瘤并非肿瘤性病变，而是由机化的心包积血组成。这表明类风湿性关节炎中的心包炎可能是出血性的，并且可酷似恶性心包肿瘤。手术决定首先得到所应用成像技术的结果、正常的心内膜活检以及临床病程的支持，随后在术中得到证实。
