Sato Ken, Kuroda Hiroyuki, Yamada Michiko, Ameda Saki, Miura Shogo, Sakano Hiroya, Shibata Takanori, Uemura Naoki, Abe Tomoyuki, Fujii Shigeyuki, Maeda Masahiro, Fujita Miri, Kobune Masayoshi, Kato Junji
Dept. of Gastroenterology and Hematology/Clinical Oncology, Internal Medicine, Steel Memorial Muroran Hospital.
Gan To Kagaku Ryoho. 2017 Oct;44(10):875-879.
A 75-year-old man was admitted to our hospital in May 2016 with progressive shortness of breath. We considered him to be experiencing acute heart failure caused by atrial fibrillation. Contrast-enhanced computed tomography showed a hypodense mass involving the right atrium and left ventricle, pericardial effusion, and lymphadenopathy of the groin. Histological finding from the groin and pericardial effusion analysis showed diffuse large B-cell lymphoma(DLBCL). We thus diagnosed this patient with cardiac tamponade owing to the involvement of the heart by DLBCL. Treatment was initiated with tetrahy- dropyranyldoxorubicin/cyclophosphamide/vincristine/prednisolone(THP-COP)therapy(50% dose)and continuous pericardial drainage. We carefully added rituximab 4 days after monitoring his symptoms and vital signs. There were a few adverse effects, and after treatment, the mass and pericardial effusion disappeared. Subsequently, 8 courses of THP-COP therapy accompanied by rituximab(R-THP-COP)(full dose)were administered, resulting in a complete response.
一名75岁男性于2016年5月因进行性气短入住我院。我们认为他正经历由心房颤动引起的急性心力衰竭。增强计算机断层扫描显示一个低密度肿块累及右心房和左心室、心包积液以及腹股沟淋巴结肿大。腹股沟和心包积液分析的组织学检查结果显示为弥漫性大B细胞淋巴瘤（DLBCL）。因此，我们诊断该患者因DLBCL累及心脏而患有心脏压塞。治疗开始时采用四氢吡喃阿霉素/环磷酰胺/长春新碱/泼尼松（THP-COP）疗法（50%剂量）并持续心包引流。在监测他的症状和生命体征4天后，我们谨慎地加用了利妥昔单抗。出现了一些不良反应，治疗后肿块和心包积液消失。随后，给予8个疗程的伴有利妥昔单抗的THP-COP疗法（R-THP-COP）（全剂量），结果达到完全缓解。
