Malouf J F, Thompson R C, Maples W J, Wolfe J T
Division of Cardiovascular Diseases, Mayo Clinic Jacksonville, FL 32224, USA.
Mayo Clin Proc. 1996 Dec;71(12):1167-70. doi: 10.4065/71.12.1167.
Traditionally, tissue diagnosis of malignant melanoma metastatic to the heart necessitated thoracotomy or was done at autopsy. More recently, right or left ventricular endomyocardial biopsy under fluoroscopic guidance has been used to confirm metastatic involvement of the heart by various neoplasms including malignant melanoma; results have been excellent, and morbidity has been low. High-quality images of intracardiac masses with excellent anatomic details can be obtained by transesophageal echocardiography. Herein we describe a 73-year-old man with a history of malignant melanoma in whom cardiac metastatic involvement was documented by percutaneous transesophageal echocardiographic-guided transvenous biopsy of a right atrial mass; thus, the need for a more invasive approach to tissue documentation was avoided.
传统上，对于转移性恶性黑色素瘤累及心脏的组织诊断需要开胸手术，或在尸检时进行。最近，在荧光镜引导下进行右心室或左心室心内膜活检已被用于确认包括恶性黑色素瘤在内的各种肿瘤对心脏的转移性侵犯；结果良好，且发病率较低。经食管超声心动图可获得具有出色解剖细节的心脏内肿块的高质量图像。在此，我们描述一名73岁有恶性黑色素瘤病史的男性，通过经皮经食管超声心动图引导下对右心房肿块进行经静脉活检记录了其心脏转移性侵犯情况；从而避免了采用侵入性更强的方法来获取组织诊断。
