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心脏影像学意外诊断的累及心脏的弥漫性大 B 细胞淋巴瘤 1 例。

A Case of Diffuse Large B-cell Lymphoma with Cardiac Involvement Incidently Diagnosed on Cardiac Imaging.

机构信息

Department of Oncology, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudia Arabia.

出版信息

J Coll Physicians Surg Pak. 2021 Sep;31(9):1102-1104. doi: 10.29271/jcpsp.2021.09.1102.

Abstract

Cardiac lymphomas, either primary or secondary, are mostly of B-cell lineage; among which, diffuse large B-cell lymphoma (DLBCL) is the most common. Secondary involvement of the heart is usually a late manifestation of disseminated lymphoma. Patients may be asymptomatic or may have non-specific symptoms, particularly when cardiac involvement is not extensive. A 22-year male patient presented with four months' history of progressive enlargement of left cervical lymph nodes with intermittent fever along with dysphagia and left ear pain. Positron-emission tomography (PET)/computed tomography (CT) scan revealed abnormal fluorodeoxyglucose (FDG) uptake in multiple systemic locations including inferior wall of the myocardium. Subsequently, cardiac MRI showed left ventricular posterolateral wall abnormal area of delayed enhancement, corresponding to the FDG uptake on PET CT scan. Patient had remission after completion of standard chemotherapy protocol for the management of DLBCL with acceptable toxicity. Key Words: Diffuse large B-cell lymphoma (DLBCL), Secondary, Heart, Chemotherapy.

摘要

心脏淋巴瘤,无论是原发性还是继发性,大多为 B 细胞来源;其中,弥漫性大 B 细胞淋巴瘤(DLBCL)最为常见。心脏的继发性累及通常是弥漫性淋巴瘤的晚期表现。患者可能无症状,也可能有非特异性症状,特别是当心脏受累不广泛时。一名 22 岁男性患者因左颈淋巴结进行性肿大伴间歇性发热、吞咽困难和左耳痛就诊,病史为四个月。正电子发射断层扫描(PET)/计算机断层扫描(CT)显示包括心肌下壁在内的多个全身部位存在异常氟脱氧葡萄糖(FDG)摄取。随后,心脏 MRI 显示左心室后侧壁异常延迟强化区,与 PET CT 扫描上的 FDG 摄取相对应。患者在完成 DLBCL 标准化疗方案治疗后达到缓解,毒性反应可接受。关键词:弥漫性大 B 细胞淋巴瘤(DLBCL),继发性,心脏,化疗。

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