Malignant Schwann tumor of left ventricle
Introduction
Introduction of left ventricular malignant Schwannoma Malignant Schwannoma is also called neurogenic sarcoma, malignant meningioma or nerve. Occurred in the limbs, such as the primary left ventricle, temporarily called the left ventricle malignant Shiwan tumor. basic knowledge The proportion of illness: 0.0003% Susceptible people: no specific population Mode of infection: non-infectious Complications: angina pectoris
Cause
Left ventricular malignant Schwannoma etiology
(1) Causes of the disease
Cardiac tumors can be primary or secondary, primary cardiac tumors are benign and common, malignant is rare, malignant Schwannoma is mostly caused by malignant transformation of neurofibromatosis or plexiform neurofibroma, or occurs in neurofibroma Patients, and those who are malignant by schwannomas, even if they are rare, generally less than 1%, occur in the left ventricle malignant Shiwanoma, whether the cause is the same as this, because the data is too small, it is difficult to determine.
(two) pathogenesis
1. Pathogenesis Malignant Schwannoma occurs in the extremities, paravertebral, mediastinal or retroperitoneal, occurs in the left ventricle is extremely rare, mostly single, but also multiple, the shape is mostly fusiform or oval, infiltrates Sexual growth, neat appearance, obvious boundary, intact or incomplete capsule, grayish white, due to tumor growth in the left ventricle, causing hemodynamic changes, resulting in the same clinical symptoms and signs as other left ventricular tumors, mainly It is the clinical manifestation of left ventricular outflow and obstruction of the inflow tract. It can be caused by different degrees of pathological manifestations due to the site, size, shape and whether it invades the myocardial or myocardial conduction tissue.
2. Pathological tumors are rich in cells, tumor cells vary in size, generally long fusiform or short fusiform, sometimes oval or polygonal epithelial-like cells, obvious nuclear nucleus, many mitotic figures, sometimes seen abnormal polynuclear cells, shuttle The bundle of tumor cells is staggered into a spiral or braided shape. The typical grid-like arrangement often disappears or is only occasionally found. The matrix between the tumor cells contains collagen fibers and mucus, sometimes see necrotic areas, which are common in malignant schwannomas. Cell-rich neurofibromatosis or plexiform neurofibromatous structures, cells infiltrating thickened nerve trunks.
Prevention
Left ventricular malignant tumor prevention
The disease is extremely rare. It is difficult to detect early because of no obvious symptoms at the early stage of the disease. Once symptoms and signs appear, the tumor has developed to a considerable size, and the condition is already critical. It should be examined quickly. Once diagnosed, early surgical treatment should be performed because of any part of the body. The malignant Schwann tumor is not sensitive to chemotherapy or radiotherapy, and surgical resection is the only effective treatment.
Complication
Left ventricular malignant Schwannoma complications Complications, angina, syncope
There may be complications such as angina pectoris and syncope.
Symptom
Left ventricular malignant Schwannoma symptoms Common symptoms Qi rush pre-heart area, distressed heart failure, syncope, palpitations, arrhythmia, shock
Left ventricular primary tumors can occur in both men and women, more men than women, more common in 6 to 30 years old, left ventricular malignant Shiwanoma age, gender, because the data is too small, it is not conclusive.
The clinical manifestations of the disease are roughly the same as those of other left ventricular tumors. They are closely related to the growth site, size and morphology of the tumor. The tumor volume is very small, often does not affect the heart function and hemodynamic changes. Clinically, symptoms and Signs, when the tumor develops to a certain size, due to changes in hemodynamic changes or myocardial contractility, resulting in symptoms and signs, can occur palpitations, shortness of breath, when the tumor affects left ventricular outflow, inflow into the channel, it often appears Obvious obstructive symptoms, mainly manifested as precordial pain or paroxysmal syncope, shock, etc. Symptoms and signs similar to mitral or aortic stenosis or regurgitation may occur due to mitral or aortic valve masses. In severe cases, conduction block, arrhythmia or heart failure may occur.
Malignant Schwann can be asymptomatic in the early stage, with the development of the tumor leading to left ventricular outflow, inflow obstruction and causing clinical manifestations of pain or syncope in the precordial area. The electrocardiogram has no obvious specificity before the tumor invades the myocardium and the conduction tissue. The line check can be normal.
Examine
Left ventricular malignant examination
1. Two-dimensional echocardiography can directly display the location, size and shape of the tumor in the heart. At the same time, it can dynamically observe the activity of the tumor and its relationship with the outflow and the incision of each valve port, which is a reliable diagnosis basis (Fig. 1).
2. X-ray tomography and magnetic resonance can be used to diagnose the histological characteristics of different tumors according to the different attenuation rates of different tumor tissues.
Diagnosis
Diagnosis and diagnosis of malignant Schwannoma of the left ventricle
diagnosis
With the development of modern imaging technology, the diagnosis of left ventricular tumor is not difficult. Two-dimensional echocardiography can directly display the location, size and shape of the tumor in the heart. At the same time, it can dynamically observe the activity of the tumor and the outflow, the mouth of each inflow port. relationship.
X-ray tomography and magnetic resonance imaging can diagnose the histological characteristics of different tumors. Traditional cardiac angiography has been rarely used. The histological diagnosis of malignant Schwannoma depends on the pathological examination of postoperative tumors.
Differential diagnosis
Myxoma is the most common type of primary benign tumor of the heart, 75% occurs in the left atrium, is rare in the left ventricle, but is more common in the primary tumor of the left ventricle, the incidence of women is slightly more, and the tumor is mostly single. Polypoid, globular or lobulated, soft and brittle, smooth surface, ranging from cherry to peach, with different lengths of tumor pedicle, pedicle elders have mobility, can block blood flow caused by symptoms, surface part Fragments of different sizes are easy to fall off and cause embolism. Two-dimensional B-ultrasound and magnetic resonance imaging studies, in addition to the judgment of the morphological characteristics of the tumor, can often make a preliminary judgment on the histological characteristics of myxoma.
Other tumors in the left ventricle still have lipoma, fibroids, capillary hemangioma, lymphangioma, teratoma, leiomyosarcoma, angiosarcoma, mesenchymal cell tumor, mesenchymal cell sarcoma, etc., mostly in preoperative and malignant Schwannoma It is difficult to identify and needs to be confirmed during the operation or postoperative pathological examination.
