Anderson Kim, Carrier Michel, Romeo Philippe, Pelletier Guy B, Liszkowski Mark, Racine Normand, White Michel, Ducharme Anique
Department of Medicine, Montreal Heart Institute, University of Montreal, 5000, Belanger East, Montreal, QC, H1T 1C8, Canada.
J Cardiothorac Surg. 2013 Jan 17;8:12. doi: 10.1186/1749-8090-8-12.
Herein we present a case of fulminant myocarditis in a woman previously treated for B-cell lymphoma. While the clinical context was suggestive of adriamycin-induced cardiomyopathy, the initial pathology of the Heartmate-2 apical core showed lymphocytic myocarditis. After 8 months of stability, the patient presented with progressive heart failure and recurrent ventricular arrhythmias. An endomyocardial biopsy revealed findings typical of giant cell myocarditis (GCM); poor response to immunosuppressive therapy and marked hemodynamic instability led to urgent transplantation. To our knowledge, this is the first reported case of GCM following an acute lymphocytic myocarditis and the second GCM case associated with B-cell lymphoma.
在此，我们报告一例曾接受B细胞淋巴瘤治疗的女性暴发性心肌炎病例。虽然临床情况提示为阿霉素诱导的心肌病，但Heartmate-2心尖核心的初始病理显示为淋巴细胞性心肌炎。在病情稳定8个月后，患者出现进行性心力衰竭和反复室性心律失常。心内膜活检显示为巨细胞心肌炎（GCM）的典型表现；免疫抑制治疗反应不佳以及明显的血流动力学不稳定导致了紧急移植。据我们所知，这是首例急性淋巴细胞性心肌炎后发生GCM的报道病例，也是第二例与B细胞淋巴瘤相关的GCM病例。
