心脏黏液瘤致脑梗死一例

doi:10.3969/j.issn.1672-6731.2023.06.010

摘要/Abstract

关键词: 卒中, 黏液瘤, 组织型纤溶酶原激活物, 血栓溶解疗法, 病例报告

Key words: Stroke, Myxoma, Tissue plasminogen activator, Thrombolytic therapy, Case reports

蒋雨锋, 黄晓琴, 周娟, 周炜, 辜强, 谭小林. 心脏黏液瘤致脑梗死一例[J]. 中国现代神经疾病杂志, 2023, 23(6): 530-534.

Yu-feng JIANG, Xiao-qin HUANG, Juan ZHOU, Wei ZHOU, Qiang GU, Xiao-lin TAN. Acute cerebral infarction induced by cardiac myxoma: one case report[J]. Chinese Journal of Contemporary Neurology and Neurosurgery, 2023, 23(6): 530-534.

http://journal11.magtechjournal.com/cjcnn/CN/Y2023/V23/I6/530

图/表 6

图 1 手术前后DSA检查所见 1a 取栓术前正位DSA显示，左大脑中动脉M1段血栓影（箭头所示） 1b 首次取栓术后即刻正位DSA显示，左大脑中动脉M2段血栓影（箭头所示） 1c 二次取栓术后即刻侧位DSA显示，左大脑中动脉闭塞段再通 1d 二次取栓术后即刻正位DSA显示，左大脑中动脉通畅，M1段和M2段血栓影消失

Figure 1 Pre - and post- thrombolysis DSA findings Anteroposteric DSA before thrombolysis showed the thrombus shadow in the M1 segment of the left MCA (arrow indicates, Panel 1a). Immediate anteroposteric DSA after initial thrombolysis showed thrombus shadow in the M2 segment of the left MCA (arrow indicates, Panel 1b). Lateral DSA after secondary thrombolysis showed recanalization of the left MCA occlusion (Panel 1c). Anteroposteric DSA after secondary thrombolysis showed the left MCA was patency, and the thrombus shadow disappeared in the M1 and M2 segments of the left MCA (Panel 1d).

图 2 光学显微镜观察可见圆形、多角形和星形细胞，伴较多黏液基质和少量玻璃样变纤维 HE染色 × 200

Figure 2 Light microscopy showed round, polygonal and stellate cells were observed with more mucous matrix and a few hyaline fibers. HE staining × 200

图 3 术后头部CT检查显示左侧基底节区高密度影逐渐减少（箭头所示） 3a 术后即刻 3b 术后第2天 3c 术后第7天

Figure 3 Postoperative CT findings showed a gradual decrease in the left basal ganglia density (arrows indicate). Immediately after thrombolysis (Panel 3a). The 2nd day after thrombolysis (Panel 3b). The 7th day after surgery (Panel 3c).

图 4 术后头部FLAIR成像显示，左侧基底节区高信号影，考虑急性脑梗死（箭头所示）

Figure 4 Postoperative head FLAIR showed hyperintensity in the left basal ganglia, suggesting acute cerebral infarction (arrow indicates).

图 5 术后超声心动图显示左心房内稍强回声团，大小约3.20 cm × 2.20 cm

Figure 5 Postoperative echocardiography showed a slightly strong echo mass in left atrium, with a size of about 3.20 cm × 2.20 cm.

图 6 光学显微镜观察可见黏液中圆形、多角形和星形细胞，细胞周围存在大量富含酸性黏多糖的疏松基质 HE染色 × 200

Figure 6 Light microscopy showed round, polygonal and stellate cells were observed in the postoperative resected mucus, surrounded by a large amount of loose matrix rich in acidic mucopolysaccharides. HE staining × 200

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