PERICARDIAL MESOTHELIOMA WITH THROMBOVASCULAR COMPLICATIONS (CASE FROM PRACTICE)
Primary mesothelioma of the pericardium is a rare heart tumor with a difficult diagnosis, revealed in vivo in less than a quarter of cases. The disease occurs at any age, more common in men and variably exhibits a broad spectrum of non-specific symptoms of congestive heart failure, constrictive peri...
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| Format: | Article |
| Language: | Russian |
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SINAPS LLC
2017-12-01
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| Series: | Архивъ внутренней медицины |
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| Online Access: | https://www.medarhive.ru/jour/article/view/724 |
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| author | N. Yu. Karpova N. S. Chipigina K. A. Rogov A. M. Sdvizhkov M. A. Rashid J. I. Banova E. M. Levin |
| author_facet | N. Yu. Karpova N. S. Chipigina K. A. Rogov A. M. Sdvizhkov M. A. Rashid J. I. Banova E. M. Levin |
| author_sort | N. Yu. Karpova |
| collection | DOAJ |
| description | Primary mesothelioma of the pericardium is a rare heart tumor with a difficult diagnosis, revealed in vivo in less than a quarter of cases. The disease occurs at any age, more common in men and variably exhibits a broad spectrum of non-specific symptoms of congestive heart failure, constrictive pericarditis, pericardial effusion or cardiac tamponade. Patients are usually observed with peripheral edema, ascites, dyspnea, cough, chest pain and atrial fibrillation. Such symptoms, in the absence of cancer alertness, are erroneously attributed by doctors to more common cardiovascular diseases. As a result, primary mesothelioma is detected in 75-90% of cases only at necropsy. The article describes a case of detection at autopsy of primary pericardial mesothelioma sarcomatous type with invasion into the myocardium in a patient of 74 years old. The patient also suffered from concomitant coronary artery disease with a long history of chronic heart failure and recurrent pulmonary embolism, associated with deep vein thrombosis at the final stage of the disease. An objective study revealed signs of chronic heart failure. The laboratory data included mild iron deficiency anemia, insignificant leukocytosis and leukocyturia, as well as signs of moderate chronic kidney disease. Instrumental results corresponded to long-term course of hypertension, signs of congestive heart failure in the presence of atrial fibrillation, atherosclerosis of lower limbs arteries in patient with abdominal obesity. Thus, there were no clinical signs of pericardial damage in a standard examination of the patient. The article describes the complexity of the disease diagnosis, variable clinical picture, as well as the diagnostic value of various instrumental methods from the perspective of evidence-based medicine. It is noted that clinical alertness is still the most important factor in the lifetime diagnosis of pericardial mesothelioma. Disease should be considered in patients with recurrent pericardial effusion, constrictive pericarditis, pericardial mass or thickening of pericardium leaflets. For reliable diagnosis of a tumor, modern imaging studies and histological examination are required. |
| first_indexed | 2024-04-10T03:56:51Z |
| format | Article |
| id | doaj.art-0e191c70c3434d9194dcb7d72e20b1d0 |
| institution | Directory Open Access Journal |
| issn | 2226-6704 2411-6564 |
| language | Russian |
| last_indexed | 2024-04-10T03:56:51Z |
| publishDate | 2017-12-01 |
| publisher | SINAPS LLC |
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| series | Архивъ внутренней медицины |
| spelling | doaj.art-0e191c70c3434d9194dcb7d72e20b1d02023-03-13T07:12:08ZrusSINAPS LLCАрхивъ внутренней медицины2226-67042411-65642017-12-017647447910.20514/2226-6704-2017-7-6-474-479648PERICARDIAL MESOTHELIOMA WITH THROMBOVASCULAR COMPLICATIONS (CASE FROM PRACTICE)N. Yu. Karpova0N. S. Chipigina1K. A. Rogov2A. M. Sdvizhkov3M. A. Rashid4J. I. Banova5E. M. Levin6Федеральное государственное бюджетное образовательное учреждение высшего образования «Российский национальный исследовательский медицинский университет имени Н.И. Пирогова» Министерства здравоохранения Российской Федерации.Федеральное государственное бюджетное образовательное учреждение высшего образования «Российский национальный исследовательский медицинский университет имени Н.И. Пирогова» Министерства здравоохранения Российской Федерации.Федеральное государственное бюджетное научное учреждение «Научно-исследовательский институт Морфологии человека».Государственное бюджетное учреждение здравоохранения «Онкологический клинический диспансер № 1 Департамента здравоохранения города Москвы».Государственное бюджетное учреждение здравоохранения «Онкологический клинический диспансер № 1 Департамента здравоохранения города Москвы».Государственное бюджетное учреждение здравоохранения «Онкологический клинический диспансер № 1 Департамента здравоохранения города Москвы».Государственное бюджетное учреждение здравоохранения «Психиатрическая клиническая больница № 1 им. Н.А. Алексеева Департамента здравоохранения города Москвы».Primary mesothelioma of the pericardium is a rare heart tumor with a difficult diagnosis, revealed in vivo in less than a quarter of cases. The disease occurs at any age, more common in men and variably exhibits a broad spectrum of non-specific symptoms of congestive heart failure, constrictive pericarditis, pericardial effusion or cardiac tamponade. Patients are usually observed with peripheral edema, ascites, dyspnea, cough, chest pain and atrial fibrillation. Such symptoms, in the absence of cancer alertness, are erroneously attributed by doctors to more common cardiovascular diseases. As a result, primary mesothelioma is detected in 75-90% of cases only at necropsy. The article describes a case of detection at autopsy of primary pericardial mesothelioma sarcomatous type with invasion into the myocardium in a patient of 74 years old. The patient also suffered from concomitant coronary artery disease with a long history of chronic heart failure and recurrent pulmonary embolism, associated with deep vein thrombosis at the final stage of the disease. An objective study revealed signs of chronic heart failure. The laboratory data included mild iron deficiency anemia, insignificant leukocytosis and leukocyturia, as well as signs of moderate chronic kidney disease. Instrumental results corresponded to long-term course of hypertension, signs of congestive heart failure in the presence of atrial fibrillation, atherosclerosis of lower limbs arteries in patient with abdominal obesity. Thus, there were no clinical signs of pericardial damage in a standard examination of the patient. The article describes the complexity of the disease diagnosis, variable clinical picture, as well as the diagnostic value of various instrumental methods from the perspective of evidence-based medicine. It is noted that clinical alertness is still the most important factor in the lifetime diagnosis of pericardial mesothelioma. Disease should be considered in patients with recurrent pericardial effusion, constrictive pericarditis, pericardial mass or thickening of pericardium leaflets. For reliable diagnosis of a tumor, modern imaging studies and histological examination are required.https://www.medarhive.ru/jour/article/view/724опухоли сердцаперикардмезотелиомазастойная сердечная недостаточностьлегочная эмболияпожилые |
| spellingShingle | N. Yu. Karpova N. S. Chipigina K. A. Rogov A. M. Sdvizhkov M. A. Rashid J. I. Banova E. M. Levin PERICARDIAL MESOTHELIOMA WITH THROMBOVASCULAR COMPLICATIONS (CASE FROM PRACTICE) Архивъ внутренней медицины опухоли сердца перикард мезотелиома застойная сердечная недостаточность легочная эмболия пожилые |
| title | PERICARDIAL MESOTHELIOMA WITH THROMBOVASCULAR COMPLICATIONS (CASE FROM PRACTICE) |
| title_full | PERICARDIAL MESOTHELIOMA WITH THROMBOVASCULAR COMPLICATIONS (CASE FROM PRACTICE) |
| title_fullStr | PERICARDIAL MESOTHELIOMA WITH THROMBOVASCULAR COMPLICATIONS (CASE FROM PRACTICE) |
| title_full_unstemmed | PERICARDIAL MESOTHELIOMA WITH THROMBOVASCULAR COMPLICATIONS (CASE FROM PRACTICE) |
| title_short | PERICARDIAL MESOTHELIOMA WITH THROMBOVASCULAR COMPLICATIONS (CASE FROM PRACTICE) |
| title_sort | pericardial mesothelioma with thrombovascular complications case from practice |
| topic | опухоли сердца перикард мезотелиома застойная сердечная недостаточность легочная эмболия пожилые |
| url | https://www.medarhive.ru/jour/article/view/724 |
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