Salisbury Thomas, Al-Mohammad Abdallah, Pirzada Omar
Internal Medical Trainee, Sheffield Teaching Hospitals, Herries Road, S5 7AU Sheffield, UK.
Consultant in Cardiology, Sheffield Teaching Hospitals, Herries Road, S5 7AU Sheffield, UK.
Eur Heart J Case Rep. 2023 Feb 18;7(3):ytad088. doi: 10.1093/ehjcr/ytad088. eCollection 2023 Mar.
Myeloid sarcoma, also known as chloroma, is a pathologic diagnosis for an extramedullary proliferation of blasts of one or more of the myeloid lineages. It is an uncommon manifestation of acute myeloid leukaemia (AML), although the diagnosis may occur prior to or after diagnosis of AML. Cardiac infiltration by myeloid sarcoma is extremely rare, and of the few published cases, a diagnosis of leukaemia was almost always already present.
This is a 52-year-old patient admitted to the hospital with acute shortness of breath, with a large amorphous mass found on computed tomography scan invading the myocardium and causing heart failure. Echocardiography demonstrated multiple cardiac masses. A bone marrow biopsy was non-diagnostic. An endomyocardial biopsy confirmed a cardiac primary myeloid sarcoma. The patient was successfully treated with chemotherapy with complete resolution of the cardiac infiltration and of the heart failure.
We present this rare case of primary cardiac myeloid sarcoma and discuss current literature relevant to this effectively unique presentation. We discuss the use of endomyocardial biopsy in the diagnosis of cardiac malignancy and the advantages of early diagnosis and management of this unusual cause of heart failure.
髓系肉瘤，也称为绿色瘤，是一种一个或多个髓系谱系原始细胞髓外增殖的病理诊断。它是急性髓系白血病（AML）的一种罕见表现，尽管诊断可能在AML诊断之前或之后出现。髓系肉瘤心脏浸润极为罕见，在少数已发表的病例中，几乎总是已经存在白血病诊断。
这是一名52岁因急性呼吸急促入院的患者，计算机断层扫描发现一个巨大的无定形肿块侵犯心肌并导致心力衰竭。超声心动图显示多个心脏肿块。骨髓活检未明确诊断。心内膜心肌活检确诊为原发性心脏髓系肉瘤。该患者通过化疗成功治疗，心脏浸润和心力衰竭完全消退。
我们报告了这例原发性心脏髓系肉瘤的罕见病例，并讨论了与这种极为独特表现相关的当前文献。我们讨论了心内膜心肌活检在心脏恶性肿瘤诊断中的应用以及早期诊断和处理这种不寻常心力衰竭病因的优势。
