Daralammouri Yunis, Hamayel Hamza, Ismail Yahya, Majadla Sajed, Odeh Razan
Department of Cardiology, An-Najah National University Hospital, Nablus, Palestine.
Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine.
SAGE Open Med Case Rep. 2022 Jan 25;10:2050313X211070942. doi: 10.1177/2050313X211070942. eCollection 2022.
Diffuse large B-cell lymphoma is the most common histologic subtype of non-Hodgkin lymphoma. Secondary involvement of the heart is seen late in advanced cases, it is uncommon for diffuse large B-cell lymphoma to present as intracardiac mass. A 26-year-old female patient presented with progressive shortness of breath, facial swelling, and lower limb edema. Imaging investigations by echocardiography and computed tomography showed a large right atrial mass that was obstructing the tricuspid valve. Open biopsy was taken, histopathology showed diffuse large B-cell lymphoma. She received six cycles R-CHOP chemotherapy (rituximab, cyclophosphamide, epirubicin, vincristine, and prednisone) with complete resolution of the mass. Diffuse large B-cell lymphoma can present with atypical and uncommon sites such as the heart as the first presentation. Early diagnosis and appropriate management is crucial given the poor outcome with late presentation. A high index of suspicion and the proper investigations is recommended to allow for early intervention and favorable outcomes as what happened with the case under discussion.
弥漫性大B细胞淋巴瘤是非霍奇金淋巴瘤最常见的组织学亚型。心脏的继发性受累在晚期病例中较常见,弥漫性大B细胞淋巴瘤表现为心内肿块并不常见。一名26岁女性患者出现进行性气短、面部肿胀和下肢水肿。超声心动图和计算机断层扫描的影像学检查显示右心房有一个大肿块,阻塞了三尖瓣。进行了开放性活检,组织病理学显示为弥漫性大B细胞淋巴瘤。她接受了六个周期的R-CHOP化疗(利妥昔单抗、环磷酰胺、表柔比星、长春新碱和泼尼松),肿块完全消退。弥漫性大B细胞淋巴瘤可表现为非典型和不常见的部位,如心脏作为首发表现。鉴于晚期表现预后较差,早期诊断和适当治疗至关重要。建议高度怀疑并进行适当检查,以便进行早期干预并取得良好结果,就像所讨论的病例那样。