心内肿瘤的治疗.ppt

Management of Intra-Cardiac Tumor心內腫瘤的治療 Shoei-Shen Wang 王水深 Professor of Cardiovascular Surgery National Taiwan University Hospital 臺大醫院 心臟血管外科 教授 壢新醫院 民國99年5月4日 2009/11/26 Regular abdominal echo for HBV follow-up Physical Exams No pitting edema No abdominal wall collaterals No other abnormal findings Lu SW F50/11/6 #3640271 姓名：呂淑呅 女士 生日： 民國 50.11.06 病歷號：3640271 病理號：S0945720 收件日期： 98.12.25 報告日期： 98.12.29 組織由來： Soft tissue, pelvic, CT-guide biopsy, smooth muscle lesion 臨床診斷： Pelvic mass with extention to IVC, RA and RV 檢查報告 The specimen submitted consists of four tissue fragments measuring up to 1.0 x 0.1 x 0.1 cm. in size fixed in formalin.Grossly, they are white and soft.All for section Jar 0Microscopically, it shows a smooth muscle lesion composed of bland-looking oval nuclei without increased cellularity, hyperchromasia or mitotic figures. Stromal hyalinization and many small vascular channels are also noted. Immunohistochemically, SMA and h-caldesmon stains are positive, confirming the smooth muscle differentiation. HMB45 stain is negative, excluding lymphangioleiomyomatosis. (Leimyomatosis) 國 立 臺 灣 大 學 醫 學 院 附 設 醫 院 National Taiwan University Hospital 心臟超音波檢查報告 姓名: 呂淑呅, 檢查日期: 2009/12/28 09:23 病歷號: 3640271 生日: 1961/11/06 性別: Female 年齡: 48 yrs Interpretation Summary Huge RA mass, measuring 5.8 x 2.4 cm2 protruding into RV. Dilated RA and RV The LV systolic function is normal, EF(Teich): 81.8?% The transmitral spectral Doppler flow pattern is suggestive of pseudonormalization.  Operation (01/13) Bilateral double-J catheter insertion Midline laparotomy Operation (1/13) Tumor resection after dissection from adjacent organs Operation (01/13) Midline sternot