Mira-Perceval Juan Gema, Alcalá Minagorre Pedro J, Huertas Sánchez Ana M, Segura Sánchez Sheila, López Iniesta Silvia, De León Marrero Francisco J, Costa Navarro Estela, Niveiro de Jaime María
Department of Pediatrics, University General Hospital of Alicante, C/Pintor Baeza 12, 03010 Alicante, Spain.
Department of Pediatric Hematology and Oncology, University General Hospital of Alicante, C/Pintor Baeza 12, 03010 Alicante, Spain.
Case Rep Pediatr. 2015;2015:487491. doi: 10.1155/2015/487491. Epub 2015 Sep 8.
The anaplastic large cell lymphoma is a rare entity in pediatric patients. We present an unusual case of pericardial involvement, quite uncommon as extranodal presentation of this type of disorder, that provoked a life-risk situation requiring an urgent pericardiocentesis. To our knowledge, this is the first report on a child with pericardial involvement without an associated cardiac mass secondary to anaplastic large cell lymphoma in pediatric age. We report the case of a 21-month-old Caucasian male infant with cardiac tamponade associated with the presentation of anaplastic large cell lymphoma. Initially, the child presented with 24-day prolonged fever syndrome, cutaneous lesions associated with hepatomegaly, inguinal adenopathies, and pneumonia. After a 21-day asymptomatic period, polypnea and tachycardia were detected in a clinical check-up. Chest X-ray revealed a remarkable increase of the cardiothoracic index. The anaplastic large cell lymphoma has a high incidence of extranodal involvement but myocardial or pericardial involvements are rare. For this reason, we recommend a close monitoring of patients with a differential diagnosis of anaplastic large cell lymphoma.
间变性大细胞淋巴瘤在儿科患者中是一种罕见的疾病。我们报告了一例心包受累的罕见病例，作为这种疾病的结外表现相当不常见，该病例引发了危及生命的情况，需要紧急进行心包穿刺术。据我们所知，这是第一例关于儿童心包受累且无继发于儿科年龄期间变性大细胞淋巴瘤的相关心脏肿块的报告。我们报告了一例21个月大的白种男婴，患有与间变性大细胞淋巴瘤表现相关的心包填塞。最初，该患儿出现持续24天的发热综合征、伴有肝肿大的皮肤病变、腹股沟淋巴结肿大和肺炎。经过21天的无症状期后，在一次临床检查中发现呼吸急促和心动过速。胸部X线显示心胸指数显著增加。间变性大细胞淋巴瘤结外受累的发生率很高，但心肌或心包受累很少见。因此，我们建议对间变性大细胞淋巴瘤进行鉴别诊断的患者进行密切监测。
