RESUMO
The presence of tumor thrombus in patients with lung cancer confers a risk of stroke and other end-organ ischemic events. This case highlights a potential role for electrocardiogram (ECG)-gated computed tomography (CT) in the diagnosis of this pathologic process. In this case, pulmonary vein thrombus was definitively identified by an ECG-CT following discordant results between CT and transthoracic echocardiogram. In addition, this case demonstrates how management decisions are affected by physician accessibility to and familiarity with specific imaging tests.
Assuntos
Eletrocardiografia , Células Neoplásicas Circulantes , Veias Pulmonares/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Trombose Venosa/diagnóstico , Ecocardiografia , Humanos , Neoplasias Pulmonares/patologia , Masculino , Pessoa de Meia-Idade , Fatores de RiscoRESUMO
We describe an adult patient with a primary left atrial leiomyosarcoma in whom live/real time three-dimensional transthoracic echocardiography showed echolucent areas within the mass consistent with necrosis or hemorrhage surrounded by dense band-like echo densities indicative of fibrosis or collagen giving a "doughnut" like appearance. These findings were consistent with histopathology, which showed areas of necrosis and dilated vascular channels within the fibrotic tumor. Our case further illustrates the usefulness of three-dimensional transthoracic echocardiography in characterizing the morphologic features of an intracardiac mass.