患者男性,13岁.因乏力、食欲不振1个月,加重伴浮肿7天来院.体格检查:心界向两则扩大,心率116次/分,未闻及杂音及心包摩擦音,腹水征阳性.胸部X线透视:心包积液(大量),双侧胸腔积液(少量).心包穿刺液常规检查:血性渗出液,结核菌、癌细胞、狼疮细胞均阴性.超声所见:心内结构及血流未见异常,心包腔内大量液性暗区环绕整个心脏,左室后壁后方液性暗区宽2.5cm,左室后方心包壁层可见2.5×1.3cm的强回声团块,外形不规则,不随体位变动而移动,后方无声影.超声诊断:心包肿瘤并大量心包积液.入院第3天再次心包穿刺抽出淡红色液体600ml,并抽出0.5×0.1cm的“烂肉样”物,病理诊断为纤维蛋白渗出物及干酪样坏死物,符合结核性心包炎.入院1周复查超声所见,心包积液较前减少,左室后壁后方液性暗区宽1.8cm,内可见网格样强回声.超声诊 Male patient, aged 13. Due to fatigue, loss of appetite for 1 month, aggravated with edema for 7 days to hospital. Physical examination: the heart to the two to expand the heart rate 116 beats / min, no smell and murmurs and pericardial rales, ascites sign positive. Chest X-ray: Pericardial effusion (large volume), bilateral pleural effusion (a small amount). Pericardial puncture fluid routine examination: bloody exudate, Mycobacterium tuberculosis, cancer cells, lupus cells were negative. Ultrasound findings: And no abnormal blood flow, pericardial cavity a lot of liquid dark area around the heart, left ventricular posterior wall liquid dark area 2.5cm wide, left ventricular pericardial wall visible 2.5 × 1.3cm strong echo mass, shape Irregular, do not move with the position change, no sound shadow at the rear Ultrasound diagnosis: pericardial tumor and a large amount of pericardial effusion On admission day 3 again pericardial pull out light pink liquid 600ml, and extract 0.5 × 0.1cm “rotten meat” , Pathological diagnosis of fibrin exudate and caseous necrosis, in line with tuberculous pericarditis .1 hospital admission review of ultrasound seen, pericardial effusion decreased compared with the former, left ventricular posterior wall of the liquid dark area 1.8cm wide, within Visible grid-like echo. Ultrasound diagnosis