[Cardiac angiosarcoma resected after definitive diagnosis by thoracoscope-assisted biopsy].

A 31-year-old woman presented with cardiac tamponade. Contrast-enhanced chest computed tomography(CT) revealed an inhomogeneously-enhanced soft tissue mass measuring 50×35×30 mm, which was in contact with the right atrial wall. The mass was definitely diagnosed as cardiac angiosarcoma by thoracoscope-assisted biopsy. The right atrial wall, including the tumor, was extensively resected, and then reconstructed with the equine pericardium. Postoperative radiation therapy was performed, but the patient developed malignant ascites with an intra-pericardial ectopic tumor recurrence. Additional radiation therapy was performed, but she died 177 days after the operation. Although thoracoscopeassisted biopsy is considered to be a useful diagnostic method for cardiac tumors on the surface of the heart, it carries the risk of spreading tumor cells. In the present case, the tumor should have been resected immediately after the prompt pathological diagnosis.

[A case of idiopathic pulmonary alveolar proteinosis with multiple localized ground-glass opacities].

A 58-year-old Japanese female consulted our staff with multiple localized ground-glass opacities in chest CT. She underwent video assisted thoracoscopic surgery for diagnosis. Histopathologic finding from surgery specimen in one of ground-glass opacities revealed bronchioloalveolar carcinoma. Six months later, we performed second video assisted thoracoscopic surgery, and histopathologic finding of all other ground-glass opacities revealed pulmonary alveolar proteinosis. Serum anti GM-CSF antibody elevated, and she was diagnosed as having idiopathic pulmonary alveolar proteinosis. A case of idiopathic pulmonary alveolar proteinosis presenting multiple localized ground-glass opacities is rare. And, differentiating ground-glass opacities of pulmonary alveolar proteinosis and bronchioloalveolar carcinoma by chest CT is difficult.