Horikoshi M, Ebina A, Imai T, Isogami K, Kaimori M, Suga M, Onodera K
Department of Respiratory Medicine, Aomori Prefectural Central Hospital, Japan.
Nihon Kyobu Shikkan Gakkai Zasshi. 1996 Mar;34(3):331-5.
A 60-year-old man presented with sudden palpitations in September 1993, and was admitted to hospital with a diagnosis of atrial fibrillation and heart failure. The patient was suspected of having collagen disease, because of a positive test for antinuclear antibodies and a high sedimentation rate. He was referred to lou hospital. Chest radiographic findings were suggestive of cardiomegaly and cardiac murmurs were audible, which indicated the presence of heart disease. A chest Ct scan revealed a lesion surrounding the intramediastinal large vessels and the heart from the level of the confluence of the left brachiocephalic vein and the superior vena cava. Suspicion of a mediastinal tumor led the patient to be admitted to the respiratory department. Percutaneous needle biopsy with a Trucut needle revealed non-specific chronic inflammation. An abdominal CT scan showed that the lesion surrounding the descending aorta traversed the diaphragm, reached the renal pelvis along both renal arteries, and caused narrowing of the ureter and left hydronephrosis. Based on these findings, retroperitoneal fibrosis was diagnosed. Treatment with steroids caused the lesion to shrink.
一名60岁男性于1993年9月出现突发心悸，因心房颤动和心力衰竭入院。患者抗核抗体检测呈阳性且血沉率高，怀疑患有胶原病。他被转诊至卢医院。胸部X线检查结果提示心脏扩大，可闻及心脏杂音，表明存在心脏病。胸部CT扫描显示，从左头臂静脉与上腔静脉汇合处水平开始，纵隔内大血管和心脏周围有一个病变。因怀疑纵隔肿瘤，患者被收入呼吸科。用Trucut针进行经皮穿刺活检显示为非特异性慢性炎症。腹部CT扫描显示，降主动脉周围的病变穿过膈肌，沿双侧肾动脉到达肾盂，并导致输尿管狭窄和左肾积水。基于这些发现，诊断为腹膜后纤维化。使用类固醇治疗后病变缩小。
