Cardiac lipoma
Introduction
Introduction to cardiac lipoma Cardiac lipoma is a benign tumor with intact outer membrane containing typical mature adipocytes. Lipomas can be located in various parts of the heart and in the pericardium. Lipomas located in the myocardium are usually small and have a complete envelope, and occasionally grow on the mitral or tricuspid valve. The patient is over 20 years old and can be as old as 70 years old, with more men than women. Clinical manifestations depend on the size and location of the tumor. Because the tumor is small, the patient generally has no symptoms and is often found during physical examination or autopsy. basic knowledge Sickness ratio: 0.0004% Susceptible people: no special people Mode of infection: non-infectious Complications: angina pectoris, arrhythmia
Cause
Causes of cardiac lipoma
Pathogenesis
The tumor tissue is composed of mature adipose tissue, usually originating from the epicardium or pericardial fat, outsourcing with fiber and a little myocardial tissue, and containing surrounding connective tissue components. The size of the tumor is different, and the influence on the heart is also different. The tumor is small, the patient rarely has symptoms, and the tumor compresses the heart and produces corresponding symptoms. However, the lipoma in the myocardium is usually small and has a complete capsule, and occasionally it grows on the mitral or tricuspid valve. Above, the microscope consists of mature fat cells.
Lipomas have intact capsules. The tumors are mainly composed of mature adipose tissue. The volume of the tumors is small, the borders are irregular, but the capsules are obvious. The pericardium and pericardium are nodules. It can be up to 10cm in diameter or larger. The cut surface is the same as mature fat or lipoma in other parts of the body. The tumor is mainly composed of mature fat lobules with different amounts of fibrous tissue, mucous tissue and blood vessels. The lipomas that occur in soft tissues are the same, and occasionally a small amount of embryonic adipocytes can be seen. When tumors occur in the myocardium, different numbers of cardiomyocytes can be seen in the tumor. It should not be misdiagnosed as cardiac rhabdomyomas. See also Less than "spider cells", in some cases, the tumor may be multiple with nodular sclerosis, or both the heart and the internal organs with lipoma and also with tuberous sclerosis.
Prevention
Cardiac lipoma prevention
At present, there is no special way to prevent the disease. It is necessary to be alert to the occurrence of this disease in the diagnosis and treatment of heart disease.
Complication
Cardiac lipoma complications Complications, angina, arrhythmia
Can cause thromboembolism, angina, arrhythmia and other complications.
Symptom
Symptoms of cardiac lipoma Common symptoms Shortness of breath ESR arrhythmia Heart sounds Weak angina Non-infectious fever Left heart failure
There is no gender difference in this disease, which can occur from any age from 0 to 77 years old. The clinical manifestation depends on the size and location of the tumor. Because the tumor is small, the patient generally has no symptoms, often found during physical examination or autopsy. When the tumor is heavily compressed, the patient's exercise tolerance may be poor. After exerting force, the air may be short, and even left heart dysfunction may occur. The heart sound may be weakened, no heart murmur or second stage systolic murmur.
Such as atrial septal lipoma can cause venous return obstruction, pericardial lipoma can oppress the heart to cause the corresponding symptoms, there are also reports of intraluminal lipoma caused by systemic fever, increased erythrocyte sedimentation rate, and even caused peripheral arterial embolism, large pericardial lipoma It may compress the coronary arteries causing angina or interfere with normal heart function. Myocardial lipoma may interfere with cardiac conduction and cause various arrhythmias.
Examine
Cardiac lipoma examination
ESR increased.
1. X-ray examination: visible heart shadow is in the middle, severely increased.
2. Cardiac ultrasound: Pericardial tumors and cystic areas can be found.
3. CT and MRI: The nature of the tumor can be inferred because the radiation density of the lipoma is low, about -50 ~ -150 Hu, which is beneficial to distinguish from other tumors.
Diagnosis
Diagnosis and diagnosis of cardiac lipoma
diagnosis
The clinical manifestations are non-characteristic. When the tumor is large and the heart function is impaired, it is often found by chance during follow-up or routine physical examination. CT and MRI can achieve the purpose of diagnosis, but in contrast, MRI is more Authoritative, because it can not only display the size, location, tissue characteristics and blood flow type of the lesion, but also can distinguish the T1 and T2 values between the tumor tissue and the surrounding tissue, which can clearly show the edge and contour of the lesion. When the body is small, it is more difficult to diagnose.
Differential diagnosis
1. Mainly different from fat infiltration or fat hypertrophy, because of its absence of envelope wrap, the contour of the lesion is unclear, and invading the myocardial tissue, sometimes with epicardial nodules, such as the vaginal thyroid.
2. To differentiate from atrial septomatous hypertrophy, atrial septomatous hypertrophy may not be a true tumor, but a non-enveloped adipose tissue hyperplasia, more common than real lipoma, atrial septal lipoma Sexual hypertrophy occurs in the lower part of the atrial septum from the atrioventricular conduction tissue of the heart, so there are often a variety of arrhythmia, some people reviewed 32 cases of lipoma hypertrophy, 28% of patients directly related to the disease, 70% The patient's age is greater than 60 years, and two-dimensional echocardiography and CT undoubtedly increase the experience of this tumor.
