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食道腺癌导致非细菌性血栓内心炎
Tosha Hedin1, Mahvish Haider1, Bhavtosh Dedania2
1Internal Medicine, HCA Healthcare University of South Florida Morsani College of Medicine, Tampa, USA.
Cureus
|July 3, 2023
概括
非细菌性血栓性内心炎 (NBTE) 是一种罕见的心脏门疾病,在患有晚期食道癌症的患者身上诊断出. 这一案例凸显了心脏和内镜评估在患有不明原因心脏病发现的患者中的重要性.
科学领域:
- 心脏病学 心脏病学
- 胃肠病学 胃肠病学
- 在瘤学瘤学.
背景情况:
- 非细菌性血栓性内心炎 (NBTE) 是一种罕见的疾病,其特点是心脏门上的非传染性植被,通常与晚期恶性瘤有关.
- 该患者是一名54岁的男性,患有心房动和胃袖手术后的肥胖症,出现了需要心脏转变的心房动.
研究的目的:
- 在一个新诊断的食道腺癌患者中报告一个罕见的NBTE病例.
- 强调TEE在确定心脏转心前心脏异常的诊断价值.
- 突出食道胃二透镜 (EGD) 在评估食道病理,特别是腹腔外科手术后的重要性.
主要方法:
- 进行过食管回声心电图 (TEE),以评估心脏结构.
- 进行了带有活检的食管胃肠镜 (EGD) 检查,以调查食管异常.
- 血液培养得到,以排除感染原因.
- 对恶性瘤进行了分期检查.
主要成果:
- TEE揭示了大,移动植被在心交上,导致心脏转变流产.
- EGD发现了一个大,的食道质量,活检证实为腺癌.
- 该患者患有晚期转移性疾病,涉及肝脏,上腺和直周淋巴结.
- 血液培养仍然呈阴性,不包括传染性内心炎.
结论:
- 这一案例强调了NBTE与晚期恶性瘤之间的关联.
- TEE对于心转变前的评估至关重要,以检测出意想不到的心脏发现.
- 对于食道癌查,EGD至关重要,特别是在有风险因素或先前胃外科手术的患者中.
- 早期检测和全面评估对于管理NBTE患者和潜在恶性瘤至关重要.
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