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恶性心包间皮瘤罕见,我院曾遇1例。患者女,63岁,因咳嗽、咯痰、劳力性心悸气短1月,不能平卧3天,于1988年5月30日以“急性全心衰竭原因待查”入院。2周前曾晕厥两次。入院即给予纠正心衰治疗不见好转,超声心动图及X线检查均发现大量心包积液,心电图为交替电压。且化验提示肝肾功能严重损伤。即行心包穿刺抽出血性液体330ml,症状仅缓解1小时即出现一过性房颤,病情急速恶化。次日,紫绀及呼吸困难进行加重,第二次穿刺抽出800ml血性液体,但终因救治无效死亡。心包积液常规化验:血性、里瓦尔塔氏实验(+),白细胞4.6×100~9/L,中性:86％,淋巴:14％。可见大圆形细胞。病理细胞学镜检:大量细胞增生活跃,部分间变,符合恶性心包间皮瘤。 讨论 恶性心包间皮瘤罕见,国内截至1988年
Malignant pericardial mesothelioma is rare and we have encountered one case in our hospital. The female patient, 63 years old, was admitted to hospital with “acute heart failure causes unknown” on May 30, 1988 because of cough, expectoration, and exertional heart palpitation shortness of one month. Two weeks before syncopation. Admission to the hospital to correct the treatment of heart failure did not improve, echocardiography and X-ray examination found a large number of pericardial effusion, ECG is alternating voltage. Tests indicated severe liver and kidney injury. The pericardial puncture pumped bloody fluid 330ml. Symptoms only eased for one hour and transient atrial fibrillation developed. The condition deteriorated rapidly. The next day, the purpura and dyspnea were aggravated. The second puncture pumped out 800 ml of bloody fluid, but eventually died due to treatment. Routine pericardial effusion tests: Blood, Rivalta’s test (+), WBC 4.6x100~9/L, Neutral: 86%, Lymph: 14%. Big round cells are seen. Pathological cytology microscopy: a large number of cell proliferation is active, part of the change, consistent with malignant pericardial mesothelioma. Discussion Malignant pericardial mesothelioma is rare, domestic as of 1988