RESUMEN
Papillary fibroelastomas are a rare form of benign cardiac neoplasm. While the majority of these lesions are asymptomatic and found incidentally via echocardiography or cardiac catheterization, those occurring on left-sided structures may become clinically important producing symptoms of syncope, angina, myocardial infarction, and sudden death. These masses also have the propensity to embolize resulting in transient ischemic attacks and strokes. Most papillary fibroelastomas are found on valvular structures and currently there are only 4 published case reports of these lesions occurring in the right atrium. Of these reports, only 3 have been presented as arising on the right atrial free wall. This case report presents the 54th known case of a papillary fibroelastoma occurring in the right atrium and the 4th to be reported as developing from the right atrial free wall. A review of the literature as well as the histogenesis, diagnosis, and therapy of this rare entity are discussed.
Asunto(s)
Fibroma/diagnóstico , Neoplasias Cardíacas/diagnóstico , Anciano , Fibroma/complicaciones , Fibroma/cirugía , Atrios Cardíacos , Neoplasias Cardíacas/complicaciones , Neoplasias Cardíacas/cirugía , Humanos , Masculino , Síncope/etiologíaRESUMEN
Positron emission tomography detects increased glucose uptake in malignant tissue using the glucose analogue [2-18F]fluoro-2-deoxy-D-glucose. We reviewed the scans obtained in 62 patients with lung tumors. All had undergone computed tomography and had tissue-based diagnoses: 22 had adenocarcinomas, 12 had squamous cell carcinomas, 13 had other malignancies, 1 had organizing pneumonia, 1 had a hamartoma, and 13 had granulomas. Positron emission tomography with [2-18F]fluoro-2-deoxy-D-glucose identified 44 of 47 malignancies. Two of three false-negative findings were tumors that were 1 cm2 or less and the other was a bronchioloalveolar carcinoma. All three false-positive findings were granulomas. The sensitivity and specificity of the technique were 93.6% and 80%, respectively, and the positive and negative predictive values were 93.6% and 80%, respectively. The differential uptake ratio was determined in all 62 patients. The mean differential uptake ratio (+/- the standard error of the mean) for malignant tumors was 6.4 +/- 0.56 and that for benign tumors was 1.14 +/- 0.26 (p < 0.0001, t test). Twenty-five of the patients had N2 lymph nodes evaluated pathologically. Positron emission tomography with [2-18F]fluoro-2-deoxy-D-glucose identified negative N2 nodes in 19 of 22 patients (86%) with negative nodes and positive N2 nodes in 2 of 3 patients (66%) with positive nodes, including one instance missed by computed tomography.(ABSTRACT TRUNCATED AT 250 WORDS)
Asunto(s)
Desoxiglucosa/análogos & derivados , Neoplasias Pulmonares/diagnóstico por imagen , Ganglios Linfáticos/diagnóstico por imagen , Tomografía Computarizada de Emisión , Desoxiglucosa/administración & dosificación , Reacciones Falso Negativas , Reacciones Falso Positivas , Femenino , Fluorodesoxiglucosa F18 , Humanos , Neoplasias Pulmonares/clasificación , Neoplasias Pulmonares/patología , Ganglios Linfáticos/patología , Metástasis Linfática , Masculino , Mediastino , Valor Predictivo de las Pruebas , Reproducibilidad de los Resultados , Estudios Retrospectivos , Sensibilidad y Especificidad , Tomografía Computarizada por Rayos XRESUMEN
A case in which a retrograde cardioplegia catheter was inserted into the coronary sinus for retrieval of antegrade cardioplegia in a patient with chronic renal failure is described. Potassium levels were maintained within normal limits throughout the procedure.