Department of Cardiology, Tosei General Hospital, Japan.
Intern Med. 2021 Feb 1;60(3):431-434. doi: 10.2169/internalmedicine.5573-20. Epub 2020 Sep 19.
Cardiac involvement of malignant lymphoma is relatively common, although such a phenomenon has subclinical manifestations that are difficult to detect. We herein describe a patient with atrial fibrillation and sick sinus syndrome as the main symptoms. Computed tomography showed a mass in the right atrium extending into the superior vena cava (SVC). We implanted the patient with a leadless pacemaker. Transvenous biopsy revealed a diffuse large B-cell lymphoma. The patient was treated successfully with chemotherapy including rituximab. This case suggested that cardiac lymphoma may cause sick sinus syndrome, and leadless pacemaker implantation is a safe treatment option in patients with partial SVC obstruction.
恶性淋巴瘤累及心脏较为常见，但其临床表现常为亚临床，难以被发现。本文报道了 1 例以心房颤动和病态窦房结综合征为主要表现的患者，CT 显示右心房内肿块延伸至上腔静脉（SVC）。我们为患者植入了无导线起搏器。经静脉活检显示弥漫性大 B 细胞淋巴瘤。该患者接受包括利妥昔单抗在内的化疗后成功治愈。该病例提示心脏淋巴瘤可引起病态窦房结综合征，对于部分 SVC 阻塞的患者，植入无导线起搏器是一种安全的治疗选择。
