肺癌转移至心包者少见,以心包积液为首发表现者更为鲜见。但随着诊疗技术的发展,晚近发生率有所提高,值得注意。我院十年来收治3例,早期均被误诊,为吸取教训,报道如下。例1:男,43岁。因气急、心悸、下肢浮肿半个月入院。查体:T37.2,BP13.33/9.33KPa。颈静脉怒张,气管居中。双肺无罗音,左肺呼吸音低,Ewart’s 征(+)。心尖搏动消失,心界向两侧扩大,心音低远,心率110次/分,律整,有吸停脉,Ku-ssmauls 征(+)。肝剑突下5cm,右肋下3cm,肝颈静脉返流征(+),双下肢Ⅱ度可凹性水肿。胸片示全心扩大,呈烧瓶状,搏动弱。心包穿刺得血性渗出液,细胞计数 It is rare for lung cancer to metastasize to the pericardium. It is even less common to have pericardial effusion as the first performer. However, with the development of diagnosis and treatment technology, the recent occurrence rate has increased, and it is worth noting. Our hospital has treated 3 cases in the past 10 years and was misdiagnosed early. In order to learn lessons, the report is as follows. Example 1: Male, 43 years old. Due to shortness of breath, palpitations, and lower extremity edema, he was admitted to the hospital for half a month. Physical examination: T37.2, BP13.33/9.33 KPa. Jugular vein engorgement, central trachea. There was no rales in the lungs, low breath sounds in the left lung, and Ewart’s sign (+). The apical beats disappeared, the heart sector expanded to both sides, the heart sound was low, the heart rate was 110 beats/minute, the regularity was aspiration, and the Ku-ssmauls sign (+). The liver xiphoid 5cm, right rib 3cm, hepatic jugular vein regurgitation sign (+), double lower limb II degree concave edema. The chest radiograph showed a full expansion, flask-shaped and weakly beating. Pericardial bloody exudate, cell count