Putterman C, Gilon D, Uretzki G, Bar-Ziv J, Polliack A
Division of Medicine, Hadassah University Hospital, Jerusalem, Israel.
Leuk Lymphoma. 1992 Jun;7(3):211-5. doi: 10.3109/10428199209053625.
Acquired right ventricular outflow tract obstruction due to extrinsic compression of the pulmonary artery is a rare manifestation of non-Hodgkin's lymphoma (NHL). We report a case of a 17 year old boy who was referred for evaluation of a large anterior mediastinal mass, causing dyspnea and cough and resulting in a harsh systolic murmur. Echocardiography demonstrated compression of the pulmonary artery by the mass, with a severe pressure gradient. Biopsy revealed intermediate grade, diffuse large cell NHL. Systemic chemotherapy rapidly led to a significant decrease in the size of the mass, and virtual disappearance of the pressure gradient. In this report, the use of echocardiography for diagnosis and follow up of extracardiac tumors is reviewed. It is suggested that this technique may also be useful for the routine staging of mediastinal lymphomas because of the potential consequences of clinically undetectable hemodynamic compromise.
由于肺动脉外部受压导致的获得性右心室流出道梗阻是非霍奇金淋巴瘤（NHL）的一种罕见表现。我们报告一例17岁男孩，因前纵隔巨大肿块前来评估，该肿块导致呼吸困难和咳嗽，并产生粗糙的收缩期杂音。超声心动图显示肿块压迫肺动脉，存在严重的压力阶差。活检显示为中级别弥漫大细胞NHL。全身化疗迅速导致肿块大小显著减小，压力阶差几乎消失。本报告回顾了超声心动图在诊断和随访心外肿瘤中的应用。由于临床无法检测到的血流动力学损害可能带来的后果，建议该技术也可用于纵隔淋巴瘤的常规分期。
