Raciti Catherine G, Alakhras Hazem, Strubchevska Kateryna, Timmis Steven, Kozyk Marko
Internal Medicine, Oakland University William Beaumont School of Medicine, Royal Oak, USA.
Internal Medicine, Corewell Health William Beaumont University Hospital, Royal Oak, USA.
Cureus. 2023 Dec 29;15(12):e51271. doi: 10.7759/cureus.51271. eCollection 2023 Dec.
While cardiac tamponade is a commonly recognized complication in solid organ malignancies and acute leukemias, instances of cardiac involvement in the context of chronic hematologic malignancies, such as chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL), are rarely observed. A 66-year-old male, with a history of stage IV CLL/SLL, presented with three weeks of worsening edema, orthopnea, and dyspnea. Two days after admission, an echocardiogram revealed a large circumferential pericardial effusion. Given the concern about early signs of pericardial tamponade, the patient underwent emergent pericardiocentesis with the removal of 700 cc of sanguineous fluid. A pericardial biopsy and flow cytometry of the pericardial fluid confirmed the diagnosis of CLL/SLL with pericardial involvement. There were no signs of large cell lymphoma transformation at that point. This rare case demonstrates the importance of considering cardiac complications in CLL/SLL patients who present with worsening edema, orthopnea, and dyspnea.
虽然心脏压塞是实体器官恶性肿瘤和急性白血病中一种常见的并发症，但在慢性血液系统恶性肿瘤（如慢性淋巴细胞白血病/小淋巴细胞淋巴瘤（CLL/SLL））的情况下，心脏受累的情况很少见。一名66岁男性，有IV期CLL/SLL病史，出现了三周的水肿加重、端坐呼吸和呼吸困难。入院两天后，超声心动图显示大量心包积液。鉴于担心心包压塞的早期迹象，患者接受了紧急心包穿刺术，抽出了700毫升血性液体。心包活检和心包液流式细胞术确诊为CLL/SLL伴心包受累。当时没有大细胞淋巴瘤转化的迹象。这个罕见的病例表明，对于出现水肿加重、端坐呼吸和呼吸困难的CLL/SLL患者，考虑心脏并发症很重要。
