A Case of Primary Malignant Fibrous Histiocytoma of the Heart With a Left-to-Right Atrial Shunt
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概要
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A previously healthy 64-year-old woman attended our hospital with chest pain, facial edema, and general fatigue. A chest radiograph revealed cardiomegaly, small bilateral pleural effusions, and hilar congestion-findings that improved after early therapy with furosemide and methyldigoxin. A chest radiograph recorded 7 years earlier had revealed no dilation of cardiac shadow. There were no findings suggesting atrial septal defect (ASD) or valvular heart disease. Echocardiography revealed a tumor-like mass adhering to the posterior wall of the left atrium. Color-flow Doppler echocardiography revealed a left-to-right shunt at the atrial level. The Q_p/Q_s ratio as measured by cardiac catheterization was 2.0. Coronary angiography revealed abnormal dilated arteries from the atrioventricular nodal branch and several feeding arteries from the left circumflex branch. We hypothesized that the left-to-right shunt could be due to the tumor, which extended to the rim of the patent foramen ovale, or to the very small, previously unrecognized, ASD. This patient died 6 months after her first admission and an autopsy was performed. Light microscopic examination of the tumor revealed spindle-shaped fibroblast-like cells arranged in a storiform or fascicular pattern. The immunohistochemical findings were consistent with malignant fibrous histiocytoma (MFH). In the literature, left-to-right shunt at the atrial level has not been reported in patients with cardiac MFH.
- 社団法人日本循環器学会の論文
- 1997-10-20
著者
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Murayama Masahiro
Division Of Cardiology St. Marianna University School Of Medicine
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Murayama Masahiro
Second Department of Internal Medicine, St Marianna University School of Medicine
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Ohkawa Shin-ichiro
Division of Cardiology, Tokyo Metropolitan Geriatric Hospital
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Miyake Fumihiko
Division Of Cardiology St. Marianna University School Of Medicine
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Miyake Fumihiko
Second Department Of Internal Medicine St Marianna University School Of Medicine
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Miyake Fumihiko
St. Marianna University School Of Medicine Division Of Internal Medicine
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Tadokoro Mamoru
Second Department Of Pathology St Marianna University School Of Medicine
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Iwasaki Tatsuya
Second Department Of Internal Medicine St Marianna University School Of Medicine
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Miyake Fumihiko
St. Marianna University School Of Medicine Internal Medicine Division Of Cardiology
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Miyake Fumihiko
The Second Department Of Internal Medicine St. Marianna University School Of Medicine
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Murayama Masahiro
Division Of Cardiology Department Of Internal Medicine St Marianna University School Of Medicine
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Aida Yoshio
Second Department Of Pathology St Marianna University School Of Medicine
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Miyamoto Seiya
Department Of Orthopedic Surgery Nakadori General Hospital
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Miyamoto Seiya
Department Of Neuropsychiatry St Marianna University School Of Medicine
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Ohkawa Shin-ichiro
Division Of Cardiology Tokyo Metropolitan Geriatric Hospital
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Ozawa Atsushi
Second Department of Internal Medicine, St Marianna University School of Medicine
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Takakuwa Toshifumi
Second Department of Pathology, St Marianna University School of Medicine
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Takakuwa Toshifumi
Second Department Of Pathology St Marianna University School Of Medicine
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Murayama Masahiro
Second Department Of Internal Medicine St Marianna University School Of Medicine
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Murayama Masahior
The 2nd Department Of Internal Medicine St. Marianna University
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Murayama Masahiro
The Second Department Of Internal Medicine St Marianna University School Of Medicine
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Ozawa Atsushi
Second Department Of Internal Medicine St Marianna University School Of Medicine
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