Alcocer Gamba Marco Antonio, León González Salvador, Castro Montes Eliodoro, Loarca Piña Luis Martín, Lugo Gavidia Leslie Marisol, García Hernández Enrique, González Galindo Ulises, Paredes Serrano Miguel Isaías
Instituto de Corazón de Querétaro, México.
Invest Clin. 2012 Sep;53(3):289-300.
Cardiac tumors are rare entities in clinical practice, with an incidence of 0.05%. Approximately 75% are benign and 25% malignant. Among these, Lymphomas are uncommon, representing about 0.25%. The non-Hodgkin lymphomas can occur in extranodal tissues in 20% of the cases and 80% of these non-Hodgkin lymphomas are composed of diffuse B cells. The extranodal presentation is most frequent in young adults, with a high degree of malignancy and rapid growth. It can present with primary infiltration of various organs; cardiac involvement occurs in 20 to 28% of cases, usually located in the right chambers and with nonspecific symptoms, depending on the location and extent of the tumor. The diagnostic test in these cases is undoubtedly the biopsy of the lymph node or the affected tissue. We present the case of non-Hodgkin disease of diffuse large cells, with right intra-atrial involvement in a 23-year-old-female patient, who presented with progressive dyspnea. A transesophageal echocardiography was performed and an intra-atrial tumor mass was detected. A biopsy was performed, by femoral venous catheterization, allowing the establishment of the histopathological diagnosis and treatment. At a one year follow up, the patient shows complete remission.
心脏肿瘤在临床实践中较为罕见,发病率为0.05%。其中约75%为良性,25%为恶性。其中,淋巴瘤并不常见,约占0.25%。非霍奇金淋巴瘤20%可发生于结外组织,且这些非霍奇金淋巴瘤中80%由弥漫性B细胞组成。结外表现多见于年轻人,恶性程度高且生长迅速。它可表现为各种器官的原发性浸润;心脏受累见于20%至28%的病例,通常位于右心房,症状不具特异性,取决于肿瘤的位置和范围。这些病例的诊断检查无疑是淋巴结或受累组织的活检。我们报告一例23岁女性弥漫大细胞型非霍奇金病,累及右心房,表现为进行性呼吸困难。行经食管超声心动图检查,发现心房内有肿瘤肿块。通过股静脉插管进行活检,得以确立组织病理学诊断并进行治疗。随访一年,患者显示完全缓解。