Orts M, Ribera J M, Calatrava A, Larrouse E, Catalán R, Navarro J T, Millá F, Feliu E
Servicio de Hematología y Hemoterapia, Hospital Universitari, Germans Trias i Pujol, Badalona.
Med Clin (Barc). 1996 Apr 13;106(14):545-7.
Although cardiac infiltration is common in advanced stage of acute leukaemia, it is not usually diagnosed at life and it is extremely rare for it to become pseudotumoral. A 25-years-old patient with an acute monoblastic leukaemia who had a leukaemic infiltration which affected the main part of the left ventricle at the time of diagnosis, is referred. The heart infiltration was detected by a two dimension echocardiography. In spite of a massive infiltration, heart failure was not present and the left ventricle's ejection fraction was 50%. Even though chemotherapy was administered, the patient died four days after diagnosis due to septic shock of respiratory origin. The most relevant autopsy finding was a widespread pseudotumoral infiltration of the left ventricle, the back side of the right ventricle and the interventricular wall. The pseudotumoral infiltration of the heart by acute leukaemia is uncommon and must be differentiated from granulocytic sarcoma. The usefulness of the different diagnostic procedures is discussed.
尽管心脏浸润在急性白血病晚期很常见,但生前通常无法诊断,形成假瘤极为罕见。本文报告一例25岁急性单核细胞白血病患者,诊断时白血病浸润累及左心室主要部分。通过二维超声心动图检测到心脏浸润。尽管有大量浸润,但未出现心力衰竭,左心室射血分数为50%。尽管进行了化疗,患者在诊断后四天因呼吸道源性感染性休克死亡。最相关的尸检发现是左心室、右心室后壁和室间隔广泛的假瘤样浸润。急性白血病心脏假瘤样浸润并不常见,必须与粒细胞肉瘤相鉴别。本文讨论了不同诊断方法的实用性。