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以心脏压塞和心脏肿块为表现的继发性心脏淋巴瘤:一例报告

Secondary cardiac lymphoma presenting with cardiac tamponade and cardiac mass: a case report.

作者信息

Lim Wei Juan, Kaisbain Neerusha, Bakar Rafidah Abu, Hadi Hafidz Abd, Mohamed Yusof Ahmad Khairuddin

机构信息

Institut Jantung Negara (National Heart Institute), 145, Jalan Tun Razak, Wilayah Persekutuan Kuala Lumpur, 50400, Malaysia.

Queen Elizabeth II Hospital, Luyang Commercial Centre, Lorong Bersatu, Off, Jalan Damai, Kota Kinabalu, Sabah, 88300, Malaysia.

出版信息

Cardiooncology. 2024 May 18;10(1):31. doi: 10.1186/s40959-024-00202-8.

Abstract

BACKGROUND

Cardiac tamponade as the presenting manifestation of systemic lymphoma is relatively uncommon. Pericardium is the commonest site of involvement in secondary malignancies with systemic lymphoma involving the heart in 20% of the cases.

CASE PRESENTATION

We describe a case of a 78-year-old gentleman, who presented with symptoms of new onset cardiac failure, and hemodynamic compromise. An echocardiography revealed cardiac tamponade, necessitating an emergency pericardiocentesis. With the aid of multimodality imaging, he was found to have a right atrioventricular groove mass, widespread lymph node enlargement with bone and peritoneal involvement. Ultimately, a histopathological evaluation revealed a diagnosis of Diffuse Large B Cell Lymphoma (DLBCL).

CONCLUSIONS

Our case illustrates that a patient with DLBCL may present with cardiac tamponade as a result of metastasis. This diagnosis, although rare, is likely to be missed, which can cause fatal complications, such as cardiac tamponade, fatal arrhythmias or sudden cardiac death.

摘要

背景

心脏压塞作为系统性淋巴瘤的首发表现相对少见。心包是继发性恶性肿瘤最常累及的部位,系统性淋巴瘤累及心脏的病例占20%。

病例介绍

我们描述了一名78岁男性患者,他出现了新发心力衰竭症状和血流动力学不稳定。超声心动图显示心脏压塞,需要紧急心包穿刺。借助多模态成像,发现他右房室沟有肿块,广泛淋巴结肿大并累及骨骼和腹膜。最终,组织病理学评估确诊为弥漫性大B细胞淋巴瘤(DLBCL)。

结论

我们的病例表明,DLBCL患者可能因转移而出现心脏压塞。这种诊断虽然罕见,但很可能被漏诊,从而导致致命并发症,如心脏压塞、致命性心律失常或心源性猝死。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6a2e/11102117/82481569f37b/40959_2024_202_Fig1_HTML.jpg

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