Department of Internal Medicine, University Hospitals Case Medical Center, Cleveland, Ohio, USA.
Cardiovasc Diagn Ther. 2014 Jun;4(3):270-3. doi: 10.3978/j.issn.2223-3652.2014.04.01.
Primary cardiac lymphomas (PCL) are very rare lymphoid malignancies that originate in the heart or pericardium. Their clinical diagnosis is often difficult, as they infrequently present with signs and symptoms consistent with cardiopulmonary conditions. Typically when B symptoms develop, (fever, weight loss, fatigue common in lymphoid malignancies), progressive heart failure will ensue. Antineoplastic treatment of PCL carries the risk of rapid tumor destruction, causing significant cardiovascular complications including life threatening arrhythmias, pericardial effusion or ventricular septal rupture. While chemotherapy is recommended to treat PCL, prognosis and response to therapy are impacted by the cardiovascular complications. In this instance, a low intensity initiation of chemotherapy followed by the standard full-dose regimen was able to achieve complete remission without cardiovascular complications. Patient monitoring in the Cardiac Intensive Care Unit (CICU) while undergoing initial cycles of chemotherapy may further offer the opportunity to institute lifesaving treatment when encountering the aforementioned cardiovascular complications.
原发性心脏淋巴瘤（PCL）是非常罕见的淋巴恶性肿瘤，起源于心脏或心包。由于其临床表现通常与心肺疾病不一致，因此临床诊断往往较为困难。通常当出现 B 症状时（淋巴瘤常见的发热、体重减轻、乏力），会进展为进行性心力衰竭。PCL 的抗肿瘤治疗有迅速破坏肿瘤的风险，导致严重的心血管并发症，包括威胁生命的心律失常、心包积液或室间隔破裂。虽然推荐使用化疗治疗 PCL，但心血管并发症会影响预后和治疗反应。在这种情况下，低强度起始化疗后再进行标准全剂量方案能够实现完全缓解，且无心血管并发症。在接受初始化疗周期时，在心脏重症监护病房（CICU）进行患者监测，当出现上述心血管并发症时，可能会有机会实施救生治疗。
