不典型恶性淋巴瘤三例误诊原因分析

目的分析不典型恶性淋巴瘤3例误诊原因,总结防范措施。方法回顾性分析误诊为其他疾病的不典型恶性淋巴瘤3例的临床资料。结果3例均因发热就诊,病初均行相关检查未能明确诊断,分别误诊为结核性心包炎、胃体黏膜慢性炎伴溃疡、泌尿系感染,均予对症处理,病情无明显好转。为进一步明确诊断行穿刺活检,1例确诊为霍奇金淋巴瘤,2例确诊为非霍奇金淋巴瘤,给予对症治疗,其中1例完成化疗后临床治愈,1例化疗过程中出现肾损伤于半年后死亡,1例治疗18个月后病情复发死亡。结论不典型恶性淋巴瘤临床表现特征不明显,不易鉴别诊断,提示临床应提高警惕,避免误诊。     

超声诊断缩窄性心包炎致肺动脉狭窄1例

患者男,41岁,主因"心慌、呼吸困难半年,加重1周"就诊.查体:心率108次/分,律齐,肺动脉瓣区可闻及2级收缩期杂音,未闻及心包摩擦音;肝大,肋下3.0 cm;心电图示:各胸导联低电压,T波低平.外院彩超诊断为左心室后壁心肌局限性突起(横纹肌肉瘤可能).本院心脏彩超检查:心包显著增厚、回声增强;左、右心房扩大,左心室腔变形,左室前外侧乳头肌移位,可见瓣下腱索附着;肺动脉缩窄,其内呈五彩镶嵌,流速增快为2.6 m/s.     

纤维心包镜在心包炎合并心包压塞诊治中的应用

大量心包积液伴心包压塞应常规行心包穿刺术，但反复穿刺抽液有可能造成血气胸和冠状动脉、心肌损伤，且心包炎有发生黏连，导致心包缩窄的可能。沧州市中心医院对182例心包炎合并心包压塞患者应用纤维心包镜诊治，效果满意。     

Pneumococcal pericarditis—Out of sight,out of mind?

Pneumococcal pericarditis has been an uncommon condition in recent years. This report describes the case of a 57-year-old woman with sarcoidosis who presented with cardiac tamponade due to pneumococcal pericarditis. She responded to pericardiocentesis and intravenous antibiotic therapy. At 4-month review, she remains well.     

Eosinophilic Pericarditis—A Rare Complication of Idiopathic Hypereosinophilic Syndrome in a Child

We describe an 18-month-old child with idiopathic hypereosinophilic syndrome (IHES) who presented with fever, and cervical lymphadenoathy. Chest X-ray showed marked cardiomegaly, and echocardiogram revealed large pericardial effusion. Other causes of pericarditis were excluded. Despite the initiation of steroid therapy, signs of impending cardiac tamponade developed. Pericardiocentesis yielded bloody fluid with a white blood count of 14,800/mm³, of which 23% were eosinophils. The child recovered after pericardial drainage and prolonged systemic steroid therapy. Eosinophilic pericarditis is a rare but potentially dangerous complication of IHES.     

Camptodactyly, arthropathy, coxa vara, pericarditis (CACP)syndrome: a case report

The camptodactyly-arthropathy-coxa vara-pericarditis syndrome (CACP) is characterized by congenital or early-onset camptodactyly, childhood-onset noninflammatory arthropathy associated with synovial hyperplasia. Some patients have progressive coxa vara deformity and/or noninflammatory pericardial effusion. CACP is inherited as an autosomal recessive mode and the disease gene is assigned to a 1.9-cM interval on human chromosome 1q25-31. We describe a 10-yr-old boy who has typical features of CACP without familial association.     

Fatal exacerbation of paraneoplastic systemic sclerosis after neoadjuvant chemotherapy in a breast cancer patient

Paraneoplastic systemic sclerosis (SSc) occurs in about 3%–7% of individuals with SSc. There are reports of accelerated SSc syndromes associated in particular with breast cancer. Further exacerbations of the rheumatic condition may be induced by treatment of the cancer. We report a 30-year-old African-American woman with a contiguous diagnosis of breast cancer and paraneoplastic SSc. She was treated with neoadjuvant chemotherapy and developed an accelerated SSc syndrome with pericarditis and cardiac tamponade, with lethal results. This case report stresses the need for control of the rheumatic condition prior to the initiation of antineoplastic therapy.Abbreviations CTGF Connective tissue growth factor - EC Endothelial cells - SSc Systemic sclerosis - TGF Transforming growth factor - TNF Tumor necrosis factor     

心包大部分切除术治疗小儿急性心包炎

目的 评价心包大部分切除术治疗小儿急性心包炎的临床效果。方法 对1992～1999年收治的35例小儿急性心包炎的手术、术后并发症及预后进行了回顾分析。结果 术后引流时间3～10d，平均5d，全组均治愈，随访半年～7年疗效满意，无远期死亡及严重并发症。结论 小儿急性心包炎应早期诊断，及时手术。心包大部分切除术，简单易行，可彻底解除心包填塞症状，避免遗留心包粘连或缩窄，缩短住院时间。目前随着结核发病率的增高，结核性心包炎的发病亦随之增加，应引起足够重视。     

系统性红斑狼疮的心脏损害

本文分析了系统性红斑狼疮并发心脏损害的78例,以心肌炎居首位,其次为心包炎,心瓣膜病,心肌梗死.