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表现异常的原发性心脏淋巴瘤:两例报告

Primary cardiac lymphoma with unusual presentation: A report of two cases.

作者信息

Chen Chiu-Fan, Hsieh Pin-Pen, Lin Shyh-Jer

机构信息

Department of Chest Medicine, Kaohsiung Veterans General Hospital, Kaohsiung 813, Taiwan, R.O.C.

Department of Pathology and Laboratory Medicine, Kaohsiung Veterans General Hospital, Kaohsiung 813, Taiwan, R.O.C.

出版信息

Mol Clin Oncol. 2017 Mar;6(3):311-314. doi: 10.3892/mco.2017.1131. Epub 2017 Jan 16.

Abstract

Primary cardiac tumors are rare, with an incidence of 0.056% according to autopsy reports. The most common type is myxoma, while other types, including sarcoma, lipoma, papillary fibroelastoma, rhabdomyoma, fibroma, hemangioma, teratoma, lymphoma and mesothelioma also occur. Primary cardiac tumors usually cause embolization, pericardial effusion and arrhythmia, leading to heart failure. Only 10% of primary cardiac tumors are malignant, approximately 95% of which are sarcomas, while the remaining 5% are cardiac lymphomas and mesotheliomas. The present study reported a case of primary cardiac lymphoma (PCL) with bilateral renal involvement and a case of PCL with bilateral adrenal gland involvement. The prognosis of PCL is poor due to the low rate of early detection and treatment. The definitive diagnosis is dependent on pathology, and timely treatment with chemotherapy can be effective. The two cases developed life-threatening arrhythmia and responded to the initial chemotherapy. In the first case, complete remission was achieved after finalization of therapy. However, the second case refused further chemotherapy and succumbed to his condition after two months.

摘要

原发性心脏肿瘤较为罕见,根据尸检报告,其发病率为0.056%。最常见的类型是黏液瘤,其他类型包括肉瘤、脂肪瘤、乳头状纤维弹性瘤、横纹肌瘤、纤维瘤、血管瘤、畸胎瘤、淋巴瘤和间皮瘤也有发生。原发性心脏肿瘤通常会导致栓塞、心包积液和心律失常,进而引发心力衰竭。原发性心脏肿瘤仅有10%为恶性,其中约95%为肉瘤,其余5%为心脏淋巴瘤和间皮瘤。本研究报告了1例伴有双侧肾脏受累的原发性心脏淋巴瘤(PCL)病例和1例伴有双侧肾上腺受累的PCL病例。由于早期发现和治疗率较低,PCL的预后较差。确诊依赖于病理学检查,及时进行化疗可能有效。这两例患者均出现危及生命的心律失常,对初始化疗有反应。第一例患者在完成治疗后实现了完全缓解。然而,第二例患者拒绝进一步化疗,两个月后病情恶化死亡。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dbb4/5403538/2cf4fc20c8da/mco-06-03-0311-g00.jpg

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