heart tumour

  • 文章类型: Journal Article
    左心房粘液瘤是二尖瓣梗阻的不典型原因。如果事态发展,突发性肺水肿可能是第一表现。
    我们提供了一例50岁女性因呼吸困难入院的病例报告。患者在住院前三年克服了中风,经胸超声心动图阴性。通过回忆和体检,假设COPD恶化,患者得到了相应的治疗。由于患者显示了许多射血分数保留的心力衰竭的危险因素,进行了经胸超声心动图检查。在左心房发现了一个巨大的息肉样肿块,导致严重的二尖瓣阻塞.随后的经食道超声心动图证实了这一发现。病人接受了紧急心脏手术,肿瘤被成功切除.组织学检查显示心脏粘液瘤。心脏手术后病人感觉很好,肿瘤没有复发。
    我们提供了一例在呼吸困难患者中偶然发现的快速生长的粘液瘤的病例报告。我们强调了肿瘤的快速生长速度以及由二尖瓣阻塞引起的肺水肿的误诊迹象。
    结论:粘液瘤是心脏最常见的原发性肿瘤,可以表现出各种症状,例如发烧,减肥,血栓栓塞,或者二尖瓣阻塞.COPD急性加重和心源性肺水肿的症状可以重叠,并且仅通过回忆和体格检查很难区分。经胸超声心动图对心脏肿块具有很高的敏感性,是怀疑这些肿块时的首选检查。
    UNASSIGNED: Myxoma of the left atrium is a less typical cause of mitral obstruction. If this develops, a flash pulmonary oedema can be the first manifestation.
    UNASSIGNED: We present a case report of a 50-year-old woman who was admitted to our internal department because of dyspnoea. The patient overcame a stroke three years before the index hospitalisation with a negative transthoracic echocardiography. By anamnesis and physical examination, an exacerbation of COPD was assumed, and the patient was treated accordingly. As the patient showed numerous risk factors for heart failure with preserved ejection fraction, transthoracic echocardiography was performed. A large polypoid mass was found in the left atrium, which caused severe mitral obstruction. Subsequent transoesophageal echocardiography confirmed this finding. The patient underwent urgent cardiac surgery, and the tumour was successfully resected. A histological examination revealed a cardiac myxoma. After the cardiac surgery the patient felt well, and no recurrence of the tumour occurred.
    UNASSIGNED: We provide a case report of a fast-growing myxoma that was incidentally found in a patient with dyspnoea. We highlight the fast growth rate of the tumour and the potential for misdiagnosed signs of pulmonary oedema caused by mitral obstruction.
    CONCLUSIONS: Myxomas are the most common primary tumours of the heart, which can manifest a variety of symptoms such as fever, weight loss, thromboembolism, or mitral obstruction.The symptoms of acute exacerbation of COPD and cardiogenic pulmonary oedema can overlap and can be difficult to differentiate by anamnesis and physical examination alone.Transthoracic echocardiography has a high sensitivity for cardiac masses and is the examination of choice when these are suspected.
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  • 文章类型: Journal Article
    目的:非心电和心电门控多探测器计算机断层扫描的特征尚未在兽医诊所得到广泛研究,但可用于心脏成像。本研究旨在确定非心电图和心电图门控方法之间的差异,并根据患者病史确定其临床实用性。
    方法:六只客户拥有的狗(两只动脉导管未闭,两个心脏基底肿瘤,一个有心包间皮瘤,和一个健康正常的人)被包括在这项研究中。所有的狗都使用非心电图门控扫描进行检查,随后进行回顾性心电图门控扫描。检查图像以确定非心电图和心电图门控图像中的最佳扫描时机和R-R间期。分别,详细的冠状动脉成像,通过对主要冠状动脉分支的视觉评估,在非心电图和心电图门控图像中最佳冠状动脉可视化的诊断质量,和左冠状动脉的分支模式。Further,我们比较了心脏或心包肿瘤患者的非心电图和心电图门控图像中心脏或心包病变的大小和边缘分界.
    结果:最佳扫描定时和R-R间隔是第二次扫描定时和舒张末期(70%-90%),分别。第二次扫描非心电图门控图像允许冠状动脉评估,在视觉评估中表明高质量,除了中隔分支.心电图门控图像,但不是非ECG门控图像,清楚地显示了两只狗的心包结节。
    结论:我们的研究结果表明,根据患者病史,使用高切片心脏计算机断层扫描进行非心电图或心电图门控成像的临床应用。
    The characteristics of non-electrocardiography- and electrocardiography-gated multidetector computed tomography have not been extensively studied in veterinary clinics but it can be useful for cardiac imaging. This study aimed to ascertain the differences between non-electrocardiography and electrocardiography gating methods and to establish their clinical utility based on patient history.
    Six client-owned dogs (two with patent ductus arteriosus, two with heart base tumour, one with pericardial mesothelioma, and one with normal health) were included in this study. All the dogs were examined using a non-electrocardiography-gated scan, followed by a retrospective electrocardiography-gated scan. Images were reviewed to determine the optimal scan timing and R-R interval in non-electrocardiography- and electrocardiography-gated images, respectively, for detailed coronary artery imaging, diagnostic quality of the best coronary artery visualisation in non-electrocardiography- and electrocardiography-gated images through visual assessment of the main coronary artery branches, and branching patterns of the left coronary artery. Further, we compared the size and margin demarcation of the heart or pericardial lesions in non-electrocardiography- and electrocardiography-gated images obtained from patients with heart or pericardial tumours.
    The optimal scan timing and R-R interval were the second-scan timing and end-diastole (70%-90%), respectively. Second-scan non-electrocardiography-gated images allowed coronary artery evaluation, indicating high-grade quality in visual assessment, except for the septal branch. Electrocardiography-gated images, but not non-ECG-gated images, clearly revealed pericardial nodules in two dogs.
    Our findings suggest the respective clinical utilities of non-electrocardiography- or electrocardiography-gated imaging using high-slice cardiac computed tomography based on patient history.
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  • 文章类型: Journal Article
    对心脏肿瘤的简短回顾提供了一个病例,清楚地表明了心内肿块的栓塞和心脏症状的表现。导致心律失常的心脏肿瘤过程的急性发作和快速进展,心脏传导障碍和心力衰竭结合高度移动的肿瘤碎片,会导致脑血管栓塞,是心脏内肿块的特征性征象.早期诊断和立即治疗可以改善长期预后,但总体预后较差。当患者出现心脏症状时,心脏病专家会出现心脏肿瘤,当出现大脑症状时,还有神经科医生。大多数心脏肿块不适合经皮活检;因此,明确的诊断通常等待手术切除。
    This short review of cardiac tumours presents a case that clearly demonstrates the manifestation of embolic and cardiac symptoms of an intracardiac mass. Acute onset and rapid progression of a neoplastic process in the heart leading to arrhythmia, cardiac conduction disorders and heart failure combined with highly mobile fragments of tumour, which can cause emboli in cerebral vessels, are characteristic signs of an intracardiac mass. Early diagnosis and immediate treatment may improve the long-term prognosis, but overall the prognosis is poor. Cardiac tumours present to the cardiologist when the patient presents with cardiac symptoms, and the neurologist when there are cerebral symptoms. Most cardiac masses are not amenable to percutaneous biopsy; therefore, definitive diagnosis often awaits surgical excision.
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  • 文章类型: Journal Article
    心脏肿瘤在儿童中极为罕见。虽然90%以上是良性的,儿童可能会出现阻塞性或栓塞性症状,心律失常,宪法症状,心脏填塞,甚至猝死.尽管大多数是无症状的,和一些自发的回归,需要根据具体情况采取适当的后续行动,因为患者可能会出现晚期症状。只有通过组织学分析才能明确诊断;然而,有可能根据成像特征以高度的确定性推断肿瘤类型,尤其是心脏磁共振.对于那些引起症状的人,提倡手术切除,阻塞,心功能不全,和栓塞的高风险。这篇综述的目的是介绍儿科人群中与心脏肿瘤相关的最新技术,根据我们自己的经验。
    Cardiac tumours are extremely rare in children. Although more than 90% are benign, children can develop obstructive or embolisation derived symptoms, arrhythmias, constitutional symptoms, cardiac tamponade, or even sudden death. Although the majority are asymptomatic, and some spontaneously regress, appropriate follow-up is needed on a case-by-case basis, as patients may develop late symptoms. Definitive diagnosis is only possible through histological analysis; however, it is possible to infer tumour type with a high grade of certainty based on imaging features, particularly cardiac magnetic resonance. Surgical resection is advocated for those causing symptoms, obstruction, cardiac dysfunction, and high risk of embolisation. The aim of this review is to present the state of the art related to cardiac tumours in the paediatric population, in the context of our own experience.
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  • 文章类型: Case Reports
    An 8-year-old female spayed German Shepherd cross was presented for acute onset of respiratory distress. Four days before presentation, the owner noticed a reduced appetite and reluctance to move. Clinical examination identified muffled lung sounds and a left base, diamond-shaped systolic murmur graded 4/6. Echocardiography identified pleural and pericardial effusion, ascites and a myxoid mass (39 mm/18.9 mm) obstructing the right ventricular outflow tract and interfering with the pulmonary valve function. Given the poor prognosis, the dog was euthanatised, and a postmortem examination was performed. Grossly, a mass with a heterogeneous appearance was identified below the pulmonary valve leaflets. Based on histopathological and immunohistochemical findings, a diagnosis of intracardiac myxosarcoma affecting the subvalvular region of the pulmonary artery was made. To the author\'s knowledge, this is the first report of right ventricle out flow tract myxosarcoma in the canine species.
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  • 文章类型: Case Reports
    BACKGROUND: Human herpesvirus-8-associated B-cell lymphoma is a common disease entity in immunocompromised individuals, particularly in patients with chronic HIV-infection or AIDS. However, cardiac manifestations are extremely rare. Tissue for histopathology of left cardiac tumours is most commonly obtained by open surgery.
    METHODS: In this report, we present a case of a solitary left atrial manifestation of an HHV8+ B-cell lymphoma in a 59-year-old patient presenting with B symptoms and a cardiac mass on echocardiography. Due to the high operative risk of the patient, a transcatheter/trans-septal biopsy was performed to establish the diagnosis.
    CONCLUSIONS: In the era of routine trans-septal catheter interventions, this approach may represent a straight-forward, minimally invasive alternative for patients at high risk for surgery.
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  • 文章类型: Journal Article
    BACKGROUND: Tumors of the heart are uncommon, and lymphangiomas are among the rarest of this group, with very few cases reported. These tumors consist of a benign slow-flow vascular malformation.
    METHODS: We report a case of a man diagnosed incidentally with a pericardial mass and our surgical approach for its treatment.
    CONCLUSIONS: The pericardial mass of our case had no cleavage plane between the myocardium and the tumor. Because of this, rather than a total resection, with very high operative risk, a biopsy was preferred. The pathology specimen showed a benign tumor and the patient was referred to the cardiologist for regular follow-up.
    CONCLUSIONS: There is no specific investigation for diagnosing cardiac lymphangiomas, and though benign, they should be considered in the differential diagnosis of other malignant diseases of the mediastinum and definitive pathologic diagnosis is mandatory. Given the increased risk of uncontrolled bleeding related to percutaneous biopsy, the definite diagnosis is usually obtained with open surgical biopsy.
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  • 文章类型: Case Reports
    据报道,左冠状动脉多发栓塞是左心房粘液瘤的罕见首发表现。通过经皮穿刺和球囊扩张治疗栓塞性心肌梗塞和充血性心力衰竭的患者。经食管超声心动图显示,绒毛粘液瘤具有高栓塞潜力。手术切除肿瘤,入院后第3天进行卵圆孔未闭缝合和扩张的三尖瓣环成形术。记录的左心室收缩功能的恢复可以通过粘液瘤物质的吸收来解释。患者在手术后10天出院。
    A case of multiple embolisms in the left coronary artery as a rare first manifestation of left atrial myxoma is reported. A patient with embolic myocardial infarction and congestive heart failure was treated by percutaneous aspirations and balloon dilatations. Transesophageal echocardiography disclosed a villous myxoma with high embolic potential. Surgical resection of the tumour, suturing of a patent foramen ovale suture and an annuloplasty of the dilated tricuspid annulus was performed the third day after the admission. Recovery of the documented left ventricular systolic function can be explained by resorption of myxomatous material. The patient was discharged ten days after the surgery.
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  • 文章类型: Case Reports
    Primary cardiac lymphoma (PCL) is the very rare disease that is associated with a high mortality rate. A prompt and proper diagnosis may affect the prognosis, and proper treatment may improve life expectancy. This report documents the case of a 74-year-old female with primary cardiac lymphoma. Unfortunately, the patient died from heart failure on her 23(rd) day in hospital.
    Pierwotny chłoniak serca jest rzadkim schorzeniem, charakteryzującym się wysoką śmiertelnością. Rokowanie poprawia szybka i właściwa diagnoza oraz leczenie. W pracy przedstawiono przypadek 74-letniej pacjentki z pierwotnym chłoniakiem serca. Niestety, kobieta zmarła w 23. dobie pobytu szpitalnego w przebiegu niewydolności serca.
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  • 文章类型: Case Reports
    The heart is the rarest site for neoplasms to be localized. Despite modern diagnostic techniques, cardiac tumours continue to among those discovered latest and with the worst prognoses. We present the case of a 62-year-old woman with a heart tumour and mediastinal lymphadenopathy, who was admitted to the Department of Cardiac Surgery. The patient underwent surgical removal of the tumour with extracorporeal circulation. The left atrium, mitral valve and the left ventricle were occupied by the infiltration. A radical resection appeared to be impossible. A valvular prosthesis was not implanted. The perioperative period was uncomplicated. On the 9(th) day a local recurrence was confirmed in the transthoracic echocardiography. Further oncological diagnostics revealed the spread of the malignant neoplasm to bones of the pelvis and spine. Chemotherapy was initiated. The authors discuss the most appropriate diagnostic and treatment procedures employed in the above case.
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