急速な増大傾向を示した左房内巨大血栓の1例

Giant Thrombus in the Left Atrium Showing a Rapid Growth：Report of a Case

はじめに　左房内血栓は全身性塞栓症や流出路への嵌頓などを生じる危険があるため，診断がつき次第すみやかな治療介入を要する．血栓形成リスクのない患者では心臓腫瘍との鑑別が困難な場合が多い．われわれは，心疾患や不整脈の既往のない患者に生じた左房内巨大血栓の症例を経験したので，若干の文献的考察を加えて報告する．

A 74-year-old woman had been on hemodialysis for about 2 months using a short-term indwelling dialysis catheter due to chronic kidney disease. A 20 mm-diameter left atrial neoplastic lesion was noted during a screening echocardiogram performed at the time of induction of hemodialysis. The lesion rapidly increased to 30 mm 2 months later and was referred to our hospital for surgical resection. Under cardiopulmonary bypass and cardiac arrest, tumor resection was performed. Although the lesion was myxomatous with a thin stalk on the left atrial ceiling, the pathological diagnosis was thrombus. After the initiation of anticoagulation, the patient was discharged.