Clinical Image
Complete Atrio-ventricular Block due to Cardiac Metastasis of Lung Adenocarcinoma
Bloqueo auriculoventricular completo debido a metástasis cardíaca de un adenocarcinoma pulmonar
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(B) Axial CT scan (parenchymal window) reveals a variant azygos lobe on the left hemithorax and aberrant left subclavian artery. (D and E) Coronal plan MIP CT images show total transposition of visceral organs accompanied with dextrocardia. (C, D and F) Sagittal, coronal and posterolateral projection 3D CT images show aberrant left subclavian artery originated from the distal of the right aortic arc. (E) Coronal MIP CT scan reveals origination and trace of the right and left carotid arteries.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Veysel Ayyildiz, Fahri Aydin, Hayri Ogul" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Veysel" "apellidos" => "Ayyildiz" ] 1 => array:2 [ "nombre" => "Fahri" "apellidos" => "Aydin" ] 2 => array:2 [ "nombre" => "Hayri" "apellidos" => "Ogul" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212920303013?idApp=UINPBA00003Z" "url" => "/15792129/0000005600000011/v1_202011120627/S1579212920303013/v1_202011120627/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S1579212920302615" "issn" => "15792129" "doi" => "10.1016/j.arbr.2020.09.001" "estado" => "S300" "fechaPublicacion" => "2020-11-01" "aid" => "2254" "copyright" => "The Author(s)" "documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "Arch Bronconeumol. 2020;56:742" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Clinical Image</span>" "titulo" => "Pulmonary Hydatidosis in a Moroccan Child" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "742" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Hidatidosis pulmonar en niña proveniente de Marruecos" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 534 "Ancho" => 1755 "Tamanyo" => 126585 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(a) Chest X-ray, anterior–posterior projection (as usually performed in pediatric patients), in which alveolar consolidation of rounded morphology is observed between the upper and lower pulmonary field of the right hemithorax, which does not obscure the right heart contour and is not delimited on the inferior edge by the horizontal fissure. Nor does it obscure the right hemidiaphragm, with consolidation located in the upper segments of the right lower lobe (as subsequently seen on CT); (b) chest CT with intravenous contrast, axial plane, mediastinal window showing organizing fluid collection of homogeneous density, with peripheral contrast uptake, located in the upper segments of the right lower lobe. The findings suggest pulmonary abscess; (c) surgical piece showing the macroscopic appearance of the excised cyst.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Alba Tomàs González, Andrés Fernando Almario Hernández, Eva Gargallo Burriel" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Alba" "apellidos" => "Tomàs González" ] 1 => array:2 [ "nombre" => "Andrés Fernando" "apellidos" => "Almario Hernández" ] 2 => array:2 [ "nombre" => "Eva" "apellidos" => "Gargallo Burriel" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S030028961930345X" "doi" => "10.1016/j.arbres.2019.07.023" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S030028961930345X?idApp=UINPBA00003Z" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212920302615?idApp=UINPBA00003Z" "url" => "/15792129/0000005600000011/v1_202011120627/S1579212920302615/v1_202011120627/en/main.assets" ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Clinical Image</span>" "titulo" => "Complete Atrio-ventricular Block due to Cardiac Metastasis of Lung Adenocarcinoma" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "743" "paginaFinal" => "744" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Saoussen Antit, Ferdaous Yangui" "autores" => array:2 [ 0 => array:3 [ "nombre" => "Saoussen" "apellidos" => "Antit" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 1 => array:4 [ "nombre" => "Ferdaous" "apellidos" => "Yangui" "email" => array:1 [ 0 => "ferdaous_yangui01@yahoo.fr" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "University of Tunis El Manar, Faculty of Medicine of Tunis, Department of Cardiology, FSI Hospital La Marsa, Tunisia" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "University of Tunis El Manar, Faculty of Medicine of Tunis, Department of Pneumology, FSI Hospital La Marsa, Tunisia" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Bloqueo auriculoventricular completo debido a metástasis cardíaca de un adenocarcinoma pulmonar" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1079 "Ancho" => 3167 "Tamanyo" => 314625 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Transthoracic echocardiogram (A) and transesophageal echocardiogram (B) showing echogenic mass (arrows) located in the interatrial septum.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 57-year-old man was referred to the hospital for evaluation of a right hilar lung mass discovered on a chest X-ray performed because of a persistent cough, increasing effort dyspnea and deterioration of the general condition. He has no medical history and had smoked 35 packs a year. On the admission, physical examination showed a slow heart rate at 40 beats per minute. The electrocardiogram showed a complete atrioventricular block. On echocardiography, a 26<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>17<span class="elsevierStyleHsp" style=""></span>mm mass was noted in the basal area of the atrial septum without interfering with the mitral valve function (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). A thoracic computed tomography (CT) scan revealed a right pulmonary hilum mass with mediastinal and peritoneal lymphadenopathy, adrenal metastasis, and a low-density mass located on the interatrial septum (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>). Fiberoptic bronchoscopy showed stenosis with mucosal tumor infiltration in the right upper lobe bronchus. The bronchial biopsy revealed a moderately differentiated adenocarcinoma. Based on these findings, the atrioventricular block was associated with interatrial septum metastasis of the lung adenocarcinoma. A pacemaker was implanted and pemetrexed platinum chemotherapy was started.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">Myocardial metastases from lung cancer are uncommon. Electrocardiographic abnormalities in include arrhythmia, conduction disturbances and complete atrioventricular blocks.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">1</span></a> Echocardiography is the best non invasive imaging technique for cardiac tumors detection. Cardiac magnetic resonance imaging (MRI), used to determine tumor morphology and to predict malignancy, has higher temporal resolution and further tissue characterization than cardiac computed tomography (CT). CT is an alternative to cardiac MRI and echocardiography.<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">2</span></a></p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "multimedia" => array:2 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1079 "Ancho" => 3167 "Tamanyo" => 314625 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Transthoracic echocardiogram (A) and transesophageal echocardiogram (B) showing echogenic mass (arrows) located in the interatrial septum.</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 2099 "Ancho" => 2167 "Tamanyo" => 289732 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">A thoracic computed tomography showing low-density mass located in the interatrial septum.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:2 [ 0 => array:3 [ "identificador" => "bib0015" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Echocardiographic and electrocardiographic manifestations of heart metastasis from primary lung cancer" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "C.-C. Chen" 1 => "M.-C. Hsiung" 2 => "M.-C. Chiang" 3 => "M.-C. Chiang" 4 => "P.-F. Yeh" 5 => "W.-T. Chang" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1076-7460.2006.04911.x" "Revista" => array:6 [ "tituloSerie" => "Am J Geriatr Cardiol" "fecha" => "2006" "volumen" => "15" "paginaInicial" => "322" "paginaFinal" => "325" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16957454" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0020" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "MR imaging of cardiac tumors and masses: a review of methods and clinical applications" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "M. Motwani" 1 => "A. Kidambi" 2 => "B.A. Herzog" 3 => "A. Uddin" 4 => "J.P. Greenwood" 5 => "S. Plein" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1148/radiol.13121239" "Revista" => array:6 [ "tituloSerie" => "Radiology" "fecha" => "2013" "volumen" => "268" "paginaInicial" => "26" "paginaFinal" => "43" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23793590" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/15792129/0000005600000011/v1_202011120627/S1579212920303001/v1_202011120627/en/main.assets" "Apartado" => array:4 [ "identificador" => "60604" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Clinical Images" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/15792129/0000005600000011/v1_202011120627/S1579212920303001/v1_202011120627/en/main.pdf?idApp=UINPBA00003Z&text.app=https://archbronconeumol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212920303001?idApp=UINPBA00003Z" ]
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