Right Atrial Intimal Sarcoma on 18F-FDG PET/CT.
- 作者列表："Janssen N","Verheyen J","Albert A
:A right atrial mass was discovered with transthoracic cardiac ultrasound in a complaint-free, 81-year-old man at his yearly cardiological checkup. Further investigation of the mass with transesophageal cardiac ultrasound showed a well-defined nodular mass of approximately 3 × 3 cm, in close proximity to the posterior wall of the right atrium. The patient underwent an F-FDG PET/CT, which showed a right atrial mass with very high FDG uptake, suggesting a malignant process. The mass was surgically removed, and anatomopathological assessment revealed an intimal sarcoma, which is a very malignant tumor and an extremely rare occurrence at this location.
: 经胸心脏超声发现右心房肿块，患者为无投诉的81岁男性，每年进行心脏检查。经食管心脏超声进一步检查肿块，显示约3 × 3厘米cm的明确结节状肿块，紧邻右心房后壁。患者接受f-fdg PET/CT，显示右心房肿块，FDG摄取非常高，提示恶性过程。手术切除肿块，解剖病理评估发现内膜肉瘤，这是一种非常恶性的肿瘤，在这个位置非常罕见。
METHODS::We present the case of a 61-year-old woman with a large tumoral infiltration extending from the pelvis throughout the inferior vena cava inferior to the right atrium, protruding into the right ventricle and right ventricular outflow tract. She had been treated 10 years before for low-grade endometrial stromal sarcoma by hysterectomy and adnexectomy followed by hormone- and radio-therapy. Due to cancer recurrence, she underwent peritonectomy, appendectomy, and resection of terminal ileum.
METHODS:AIMS:Significant platelet activation after long stented coronary segments has been associated with periprocedural microvascular impairment and myonecrosis. In long lesions treated either with an everolimus-eluting bioresorbable vascular scaffold (BVS) or an everolimus-eluting stent (EES), we aimed to investigate (a) procedure-related microvascular impairment, and (b) the relationship of platelet activation with microvascular function and related myonecrosis. METHODS AND RESULTS:Patients (n=66) undergoing elective percutaneous coronary intervention (PCI) in long lesions were randomised 1:1 to either BVS or EES. The primary endpoint was the difference between groups in changes of pressure-derived corrected index of microvascular resistance (cIMR) after PCI. Periprocedural myonecrosis was assessed by high-sensitivity cardiac troponin T (hs-cTnT), platelet reactivity by high-sensitivity adenosine diphosphate (hs-ADP)-induced platelet reactivity with the Multiplate Analyzer. Post-dilatation was more frequent in the BVS group, with consequent longer procedure time. A significant difference was observed between the two groups in the primary endpoint of ΔcIMR (p=0.04). hs-ADP was not different between the groups at different time points. hs-cTnT significantly increased after PCI, without difference between the groups. CONCLUSIONS:In long lesions, BVS implantation is associated with significant acute reduction in IMR as compared with EES, with no significant interaction with platelet reactivity or periprocedural myonecrosis.
METHODS:BACKGROUND:Aortopulmonary window is an uncommon congenital heart disease, with untreated cases not surviving beyond childhood. However, very rarely it can present in adult patients with features of pulmonary hypertension. Clinically these patients cannot be differentiated from other more common conditions with left to right shunt. Transthoracic echocardiography if performed meticulously, can depict the defect in aortopulmonary septum. RESULTS:We report a case of large unrepaired aortopulmonary window in a 23 years old patient, diagnosed on transthoracic echocardiography.