| Japanese |
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| Title | 放射線治療16年後に慢性収縮性心膜炎をきたした1例 |
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| Subtitle | 症例報告 |
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| Authors | 広瀬義晃*, 石田良雄*, 林田孝平*, 濱田星紀*, 外山卓二*, 宮武邦夫**, 今北正美***, 植原敏勇****, 西村恒彦***** |
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| Authors(kana) | |
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| Organization | *国立循環器病センター放射線診療部, **心臓内科, ***病理, ****大阪大学医学部附属病院中央放射線部, *****バイオメディカル教育研究センタートレーサ情報解析 |
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| Journal | 核医学 |
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| Volume | 30 |
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| Number | 9 |
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| Page | 1091-1096 |
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| Year/Month | 1993/9 |
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| Article | 報告 |
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| Publisher | 日本核医学会 |
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| Abstract | 「要旨」放射線照射16年後に慢性収縮性心膜炎をきたした1例を報告する. 症例は51歳女性. 29歳時に乳癌にて左乳房切除術, 放射線照射を受けた. 放射線治療16年後に完全房室ブロックを発症しペースメーカ植込み術を施行されたが, その際, 慢性収縮性心膜炎と診断された. その後, 三尖弁閉鎖不全を合併し, 心不全を呈した. 核医学的には67Gaシンチグラフィにて心臓部への集積, および99mTc-human serum albumin (HSA) 心プールシンチグラフィにて右房の拡大, 心膜液貯留が認められた. さらに201Tl安静時心筋シンチグラフィにて右室心筋欠損像を認め, 右室心筋障害の合併が示唆された. 病理学的には心膜肥厚, 癒着および右室心筋と刺激伝導路の線維化が認められ, 核医学検査所見と一致した. 最近の放射線治療の進歩により患者の予後が改善し, 放射線治療後の収縮性心膜炎の患者を診察する機会は少なくないと思われる. 特に, 本例のように慢性的経過をとる場合, 核医学検査が経過観察に有用と考えられた. |
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| Practice | 臨床医学：一般 |
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| Keywords | Pericarditis, Radiation-induced, Breast cancer. |
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| English |
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| Title | A Case of Radiation-Induced Chronic Constrictive Pericarditis Developing 16 Years after Irradiation |
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| Subtitle | Case Reports |
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| Authors | Yoshiaki HIROSE*, Yoshio ISHIDA*, Kohei HAYASHIDA*, Takuji TOYAMA*, Seiki HAMADA*, Kunio MIYATAKE**, Masami IMAKITA***, Toshiisa UEHARA****, Tsunehiko NISHIMURA**** |
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| Authors(kana) | |
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| Organization | *Department of Radiology, **Department of Internal Medicine, ***Department of Pathology, National Cardiovascular Center, ****Osaka University Medical School |
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| Journal | The Japanese Journal of nuclear medicine |
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| Volume | 30 |
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| Number | 9 |
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| Page | 1091-1096 |
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| Year/Month | 1993/9 |
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| Article | Report |
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| Publisher | THE JAPANESE SOCIETY OF NUCLEAR MEDICINE |
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| Abstract | [Summary] We reported a 51-yr-old female with radiation-induced chronic constrictive pericarditis. At age 29, she had received a mastectomy and postoperative irradiation because of left breast cancer. At age 45, she had syncope and was diagnosed with complete atrioventricular block and a pacemaker was implanted. At that time, pericardial thickening with effusion was noted. The following year, tricuspid regurgitation was noted. On catheter study, a dip and plateau pattern of the right ventricular pressure curve appeared. At age 50, tricuspid regurgitation worsened due to the lead wire of the pacemaker compressing the leaflet, and the pacemaker was reimplanted. However, the following year, she complained of general fatigue and dyspnea and was admitted to our hospital. On 67Ga study, diffuse accumulation in the cardiac region appeared. There was no perfusion defect detected in the left myocardium, but right myocardial damage was suspected by thallium study. In 99mTc-HSA RI angiography, right atrium dilatation appeared and a pericardial halo around the ventricles was seen. She underwent pericardectomy, tricuspid replacement and pacemaker reimplanted, but she died. On autopsy, pericardial thickening and adhesion, right myocardial fibrosis, the fibrotic change of the bundle branches were seen. We reported a case of radiation-induced constrictive pericarditis. Radionuclide studies were useful in diagnosing and following the patient. |
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| Practice | Clinical medicine |
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| Keywords | Pericarditis, Radiation-induced, Breast cancer. |
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