Grollier G, Troussard X, Agostini D, Commeau P, Bertrand J H, Fossier J M, Parisot M, Lamy E, Leporrier M, Foucault J P
Arch Mal Coeur Vaiss. 1987 May;80(5):651-6.
In a recently published post-mortem series the incidence of cardiac lesions in malignant lymphoma was estimated at about 8.7%. These lesions rarely produce specific cardiac symptoms; they usually are late manifestations of a disease with multiple secondary lesions or are discovered at autopsy. In most patients the lesions are not limited to the heart but represent the extension to that organ of a malignant lymphoma. We observed two cases of cardiac lesions secondary to malignant non-Hodgkin lymphoma and we were able to evaluate their response to chemotherapy. In the first patient the cardiac symptoms revealed the lymphoma; in the second patient the cardiac involvement was discovered 4 years after the lymphoma was diagnosed. In both cases the cardiac lesions were detected by two-dimensional echocardiography. They presented as polypoid masses filling the right atrium and associated with periaortic thickening in the first case, and as a large heterogeneous mass including a tricuspid valve leaflet and extending to the free wall of the right ventricle in the second case. Pericardial effusion was present in the two patients. These echocardiographic findings were confirmed computerized tomography and catheterization. In the first case, followed up for one year, the echocardiographic images reverted to normality after chemotherapy. The second patient, unfortunately, did not respond to chemotherapy and deteriorated rapidly.
在最近发表的一组尸检研究中，恶性淋巴瘤中心脏病变的发生率估计约为8.7%。这些病变很少产生特定的心脏症状；它们通常是一种伴有多种继发性病变的疾病的晚期表现，或在尸检时被发现。在大多数患者中，病变并不局限于心脏，而是代表恶性淋巴瘤向该器官的扩展。我们观察了两例继发于恶性非霍奇金淋巴瘤的心脏病变，并能够评估它们对化疗的反应。在第一例患者中，心脏症状揭示了淋巴瘤；在第二例患者中，心脏受累在淋巴瘤诊断4年后被发现。在这两例中，心脏病变均通过二维超声心动图检测到。在第一例中，病变表现为充满右心房的息肉样肿块，并伴有主动脉周围增厚；在第二例中，表现为一个大的不均匀肿块，包括一个三尖瓣小叶，并延伸至右心室游离壁。两名患者均有心包积液。这些超声心动图表现经计算机断层扫描和心导管检查得以证实。在第一例中，随访一年，化疗后超声心动图图像恢复正常。不幸的是，第二例患者对化疗无反应，并迅速恶化。
