Loire R, Hellal H
Laboratoire d'Anatomie pathologique, Hôpital cardiovasculaire et pneumologique Louis-Pradel, Lyon.
Presse Med. 1993 Feb 20;22(6):244-8.
Between 1969 and 1992, eighty cases of malignant pericarditis were studied by thoracotomy and biopsy, which made it possible not only to assert the diagnosis but also to dry the pericardial effusion by creating a pleuro-pericardial window. In 75 cases a cardiac tamponade of varying severity required surgical heart decompression. Pericarditis revealed the neoplasia in 53 cases and complicated a known cancer in 27 cases (23 carcinomas, 2 malignant melanomas included). In 63 cases (2 metastatic malignant melanomas, 7 sarcomas and 54 carcinomas) the disease was rapidly fatal. On the other hand, 17 patients with certain types of neoplasia revealed by pericarditis (12 with malignant lymphoma, 5 with non-encapsulated thymoma) have survived under an appropriate treatment. In addition to curing the immediately life-threatening tamponade, thoracotomy with pericardial biopsy determines the nature of the lesion and, consequently, its specific treatment.
1969年至1992年间,对80例恶性心包炎患者进行了开胸手术及活检研究,这不仅有助于明确诊断,还能通过建立胸膜心包窗来引流心包积液。75例患者出现了不同程度的心包填塞,需要进行外科心脏减压。心包炎在53例中揭示了肿瘤,在27例中并发了已知癌症(包括23例癌、2例恶性黑色素瘤)。63例患者(2例转移性恶性黑色素瘤、7例肉瘤和54例癌)病情迅速恶化死亡。另一方面,17例因心包炎发现特定类型肿瘤的患者(12例恶性淋巴瘤、5例非包膜性胸腺瘤)在适当治疗下存活。除了治愈即刻危及生命的心包填塞外,开胸心包活检还能确定病变性质,从而确定其具体治疗方法。