Simek J, Král B, Langr F
Department of Cardiothoracic Surgery, University Hospital, Hradec Králové, Czech Republic.
Sb Ved Pr Lek Fak Karlovy Univerzity Hradci Kralove. 1993;36(4-5):337-43.
Case of the 47-year-old man, clinically suffering from recurrent dyspnoea, cough, syncopes, haemoptysis, unsuccessfully treated with anticoagulant and fibrinolytic agents, is described. Large masses of a tumour, occupying nearly the whole lumen of pulmonary artery and extending to peripheral branches, were removed during surgery. The tumour was histologically and immunohistochemically classified as myxosarcoma. Following surgery, the patient was asymptomatic, could do his original job (lorry-driver) for the next 14 months. He died 20 months after surgery, showing symptoms and signs of progressive right heart failure. At autopsy, the tumourous obliteration of the pulmonary artery and adjacent thrombosis were found. Primary pulmonary artery sarcoma should be considered in the differential diagnosis of recurrent pulmonary thromboembolism, especially when no peripheral vein thrombosis could be found.
描述了一名47岁男性患者的病例,该患者临床上患有反复发作的呼吸困难、咳嗽、晕厥、咯血,使用抗凝剂和纤溶药物治疗均未成功。手术中切除了大量肿瘤,肿瘤几乎占据了肺动脉的整个管腔并延伸至外周分支。该肿瘤经组织学和免疫组织化学分类为黏液肉瘤。手术后,患者无症状,在接下来的14个月里能够从事原来的工作(卡车司机)。他在手术后20个月死亡,表现出进行性右心衰竭的症状和体征。尸检发现肺动脉肿瘤性闭塞及相邻血栓形成。在复发性肺血栓栓塞的鉴别诊断中应考虑原发性肺动脉肉瘤,尤其是在未发现外周静脉血栓形成时。