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題名 | Cardiac Angiosarcoma Presents as Pulmonary Hemorrhage=心臟血管瘤以廣泛性肺出血表現 |
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作者 | 張基晟; 吳杰亮; 徐武輝; 江自得; | 書刊名 | 胸腔醫學 |
卷期 | 13:1 1998.03[民87.03] |
頁次 | 頁15-20 |
分類號 | 415.38 |
關鍵詞 | 心臟血管瘤; 廣泛性肺出血; Cardiac angiosarcoma; Diffuse alveolar hemorrhage; |
語文 | 英文(English) |
中文摘要 | 臨床上要診斷廣泛性肺出血常常是相當困難。心臟血管瘤是相當罕見但卻是高度 侵襲性之惡性腫瘤。我們提出三例心臟血管瘤以廣泛性肺出血表現。這三病人最初都以走路 會喘及血性心包膜來表現。後來胸部x光出現兩側廣泛性肺泡浸潤。這三病人都有接受胸部 電腦斷層檢查,進而得知右心房壁且或右心室腫瘤。而其中二人有接受胸都核磁共振掃瞄得 到類似結果。然而經胸心臟超音波只偵測出其中一位較廣泛巨大之腫瘤。這三病人最後都是 經由外科手術得到確定診斷。 臨床上當病人x光出現兩側廣泛性肺泡浸潤及血性心包膜,心臟血管瘤應被列為鑑別診斷之 一。根據我們的經驗,經胸心臟超音波在診斷右心房壁腫瘤有其死角。而在這方面電腦斷層 及核磁共振掃瞄似乎有較好的診斷率。 |
英文摘要 | Diffuse alveolar hemorrhage (DAH) often causes difficulty in diagnosis. Primary cardiac angiosarcoma is a rare and highly aggressive malignancy. Here we present three cases of cardiac angiosarcoma with diffuse pulmonary hemorrhage. All the patients had dyspnea on exertion and bloody pericardial effusion initially, with chest radiographs (CXR) revealing bilateral diffuse alveolar patches. Thoracic computed tomography (CT) revealed masses over the right atrium (RA) and/or the right ventricle (RV). Two patients underwent chest magnetic resolution imaging (MRI) with compatible findings. Only one case was detected by transthoracic echocardiogram. Diagnoses were confirmed by surgical intervention. Cardiac angiosarcoma should be considered in patients with diffuse alveolar patches on the CXR and bloody pericardial effusion. In our experience, transthoracic echocardiogram had some limitations in detecting the right atrial masses, but thoracic CT and MRI may be superior in the detection of cardiac tumors. |
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