Veliki intraperikardni lipom: kliničke i forenzičke implikacije

  • Milenko Bogdanović University of Belgrade, Faculty of Medicine, Institute of Forensic Medicine “Milovan Milovanović”, Belgrade, Serbia
  • Snežana Pavlekić University of Belgrade, Faculty of Medicine, Institute of Forensic Medicine “Milovan Milovanović”, Belgrade, Serbia
  • Maja Milošević Institute for Cardiovascular Diseases “Dedinje”, Department of Cardiology, Belgrade, Serbia
  • Bojana Radnić University of Belgrade, Faculty of Medicine, Institute of Forensic Medicine “Milovan Milovanović”, Belgrade, Serbia
  • Jovana Lakčević Institute for Cardiovascular Diseases “Dedinje”, Department of Cardiology, Belgrade, Serbia
  • Stefan Veljković Institute for Cardiovascular Diseases “Dedinje”, Department of Cardiology, Belgrade, Serbia
  • Djordje Alempijević University of Belgrade, Faculty of Medicine, Institute of Forensic Medicine “Milovan Milovanović”, Belgrade, Serbia
  • Miloš D. Babić Institute for Cardiovascular Diseases “Dedinje”, Department of Cardiology, Belgrade, Serbia
DOI: https://doi.org/10.2298/VSP200922023B
Ključne reči: autopsija, smrt, uzrok, dijagnoza, lipom, infarkt miokarda, perikard, sinkopa

Sažetak


Uvod. Lipomi su najčešći benigni tumori, ali su retko lokalizovani u perikardnoj šupljini. Mada benigni po svojim patohistološkim karakteristikama, zbog ubrzanog rasta i posledičnih komplikacija koje mogu ugroziti život, mogu se klinički smatrati malignim. Prikaz bolesnika. Prikazana je 80-godišnja žena, koja je nakon epizode sinkope, pri padu sa sopstvene visine, zadobila telesne povrede zbog kojih je hospitalizovana. U daljem toku kratkotrajnog bolničkog lečenja nastupio je smrtni ishod, a uzrok smrti označen je kao „nepoznat”. Obdukcijom je utvrđen uvećan i napet perikard, koji je ispunjavao značajan deo grudne duplje. Dobro inkapsulirana tkivna masa dimenzija 20 × 18 × 3 cm, težine 820 g, uočena je intraperikardno. Histopatološkom analizom pokazano je da je uočena promena lipom, a na srčanom mišiću uočeni su znaci akutne nekroze miokarda, na osnovu čega je pretpostavljeno da je infarkt miokarda najverovatnije nastao kao posledica pritiska lipoma na koronarne arterije. Zaključak. Intraperikardni lipomi mogu biti maligni po lokalizaciji i dovesti do iznenadne srčane smrti. Postoje različite dijagnostičke metode pomoću kojih je moguće otkrivanje intraperikardnih lipoma, a pravovremenom intervencijom bolesnik može biti izlečen.

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Objavljeno
2023/04/30
Broj časopisa
Vol. 80 Br. 03 (2023): Vojnosanitetski pregled
Rubrika
Prikaz bolesnika