Cay Serkan, Durak Akif, Aydoğdu Sinan, Turhan Nesrin
Department of Cardiology, Türkiye Yüksek Ihtisas Heart-Education and Research Hospital, Ankara, Turkey.
Turk Kardiyol Dern Ars. 2009 Dec;37(8):578-9.
Pericardial effusion might be the first presentation of various pathologies including malignant tumors. Massive pericardial effusion as the primary manifestation of high-grade malignant lymphoma is a very rare condition. A 53-year-old woman presented with progressive dyspnea of one-week history. Physical examination showed venous distention of the neck veins and diminished heart sounds. The chest X-ray demonstrated increased cardiothoracic index. Transthoracic and transesophageal echocardiographic examinations showed massive pericardial effusion without any other pathology. Hematologic and biochemical tests showed only anemia. The patient underwent pericardiocentesis. Pericardial adenosine deaminase test and cultures were negative. Cytopathologic examination of the fluid showed huge lymphocytes and highly atypical lymphoid cells consistent with high-grade malignant lymphoma (non-Hodgkin's lymphoma). Immunohistochemical analysis showed positivity for leukocyte common antigen. No other primary origin could be determined.
心包积液可能是包括恶性肿瘤在内的各种病症的首发表现。大量心包积液作为高级别恶性淋巴瘤的主要表现非常罕见。一名53岁女性出现了为期一周的进行性呼吸困难。体格检查显示颈静脉怒张且心音减弱。胸部X线显示心胸比率增加。经胸和经食管超声心动图检查显示大量心包积液，未发现任何其他病变。血液学和生化检查仅显示贫血。患者接受了心包穿刺术。心包腺苷脱氨酶检测和培养均为阴性。液体的细胞病理学检查显示有大量淋巴细胞和高度异型的淋巴样细胞，符合高级别恶性淋巴瘤（非霍奇金淋巴瘤）。免疫组织化学分析显示白细胞共同抗原呈阳性。未发现其他原发灶。
