在患有转移性肺癌的患者中延迟诊断非细菌性血栓内心炎
Efe Opone1, Reza Aghamohammadzadeh2
1Medicine, University Hospitals Sussex, Hove, GBR.
Cureus
|October 30, 2025
概括
非细菌性血栓性内心炎 (NBTE) 呈现为心脏门上的无菌植被,通常与癌症有关. 这一案例凸显了NBTE诊断的挑战以及恶性瘤相关病例的不良预后.
科学领域:
- 心脏病学 心脏病学
- 在瘤学瘤学.
- 病理学 病理学 病理学
背景情况:
- 非细菌性血栓性内心炎 (NBTE) 的特点是心脏门上的无菌植被,经常与恶性瘤或慢性炎症相关.
- 诊断NBTE往往是延迟的,临床表现通常发生在栓塞并发症发生后.
研究的目的:
- 在患有转移性腺癌的患者中报告NBTE病例.
- 强调NBTE在晚期恶性瘤的诊断挑战和临床影响.
主要方法:
- 一个42岁的男性患者的病例报告呈现出暗示栓塞事件和心脏损害的症状.
- 诊断工作包括计算机断层扫描肺血管造影 (CTPA),胸前心脏回声,心周液分析和转移性疾病的成像.
- 评估临床表现,实验室发现和成像结果,以确定NBTE的诊断.
主要成果:
- 患者出现呼吸不全,疲劳,贫血,血小板缺血,心周溢血,严重的大动脉吐,并怀疑大动脉植被.
- 细胞检测证实了转移性腺癌,成像显示了全身栓塞 (脏和脏梗塞).
- 对NBTE的诊断是基于无菌植被,全身栓塞和潜在的恶性瘤建立的.
结论:
- 在患有复发性栓塞事件的患者中,特别是那些已知或怀疑患有恶性瘤的患者中,应考虑NBTE.
- 虽然抗凝药可以减轻进一步的栓塞风险,但与癌症相关的NBTE的预后仍然很差.
- 启动了支持性治疗,由于传播恶性瘤和预后不佳,推迟了手术干预.
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