Katz Heather, Rose Cielo, Rivera Nina Thakker, Bray Natasha
Department of Internal Medicine, Broward Health Medical Center, Fort Lauderdale, Florida, USA.
BMJ Case Rep. 2015 Feb 27;2015:bcr2014208718. doi: 10.1136/bcr-2014-208718.
Primary effusion lymphoma (PEL), a rare type of non-Hodgkin's lymphoma, is an AIDS-defining illness and always associated with human herpesvirus 8 (HHV-8). Classic presentations involve the pleural, pericardial or peritoneal cavities. Infrequently, extracavitary solid tumours develop. Treatment of PEL requires chemotherapy and highly active antiretroviral therapy (HAART). We report a case of a 46-year-old man, who presented with right-sided chest pain, dyspnoea and night sweats. Evaluation revealed decreased breath sounds and dullness to percussion on the right side of the chest. Imaging demonstrated a 6.1 cm×6.3 cm right paracardial mass and right-sided pleural effusion. Pleural fluid was HHV-8 positive. The patient was diagnosed with PEL with extracavitary involvement and treated with chemotherapy and concurrent HAART. This case is the first reported case of extracavitary paracardial involvement and adds new insight to the accepted treatment for PEL with extracavitary lesions.
原发性渗出性淋巴瘤（PEL）是一种罕见的非霍奇金淋巴瘤，是一种艾滋病界定疾病，常与人类疱疹病毒8型（HHV-8）相关。典型表现累及胸膜腔、心包腔或腹膜腔。偶尔也会出现腔外实体瘤。PEL的治疗需要化疗和高效抗逆转录病毒治疗（HAART）。我们报告一例46岁男性病例，该患者出现右侧胸痛、呼吸困难和盗汗。评估发现右侧呼吸音减弱，胸部叩诊呈浊音。影像学检查显示右心旁有一个6.1 cm×6.3 cm的肿块及右侧胸腔积液。胸水HHV-8呈阳性。该患者被诊断为伴有腔外受累的PEL，并接受了化疗及同时进行的HAART治疗。该病例是首例报道的心旁腔外受累病例，为伴有腔外病变的PEL的公认治疗方法增添了新的见解。
