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酷似心脏肿瘤的原发性心脏淋巴瘤:一例右心室肿块伴七年缓解的罕见病例

Primary Cardiac Lymphoma Mimicking Cardiac Tumor: A Rare Case of Right Ventricular Mass With Seven-Year Remission.

作者信息

Leivaditis Vasileios, Papatriantafyllou Athanasios, Panagiotopoulos Ioannis, Dahm Manfred, Lozos Vasileios

机构信息

Department of Cardiothoracic and Vascular Surgery, Westpfalz-Klinikum, Kaiserslautern, DEU.

Department of Cardiac Surgery, Ippokrateio General Hospital, Athens, GRC.

出版信息

Cureus. 2025 Jan 3;17(1):e76864. doi: 10.7759/cureus.76864. eCollection 2025 Jan.

Abstract

Primary cardiac lymphoma (PCL) is an exceedingly rare extranodal lymphoma type that typically presents with nonspecific symptoms such as arrhythmias or heart failure. This report details the case of a 67-year-old male with a right ventricular mass, ultimately diagnosed as diffuse large B-cell lymphoma (DLBCL) of the germinal center B-cell (GCB) subtype. Initial chemotherapy with the CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone) regimen was insufficient, necessitating the addition of rituximab and subsequent mycophenolate therapy to manage immune thrombocytopenia. Through prolonged treatment and management of complications, the patient achieved remission and has remained disease-free over a seven-year follow-up period. This case highlights the diagnostic and therapeutic challenges of PCL, especially when associated with immune thrombocytopenia and suspected sternal osteomyelitis, underlining the importance of a multidisciplinary approach.

摘要

原发性心脏淋巴瘤(PCL)是一种极为罕见的结外淋巴瘤类型,通常表现为心律失常或心力衰竭等非特异性症状。本报告详细介绍了一例67岁男性患者,其右心室有肿块,最终被诊断为生发中心B细胞(GCB)亚型的弥漫性大B细胞淋巴瘤(DLBCL)。最初采用CHOP(环磷酰胺、阿霉素、长春新碱和泼尼松)方案进行化疗效果不佳,因此需要加用利妥昔单抗并随后采用霉酚酸酯治疗以控制免疫性血小板减少症。通过长期治疗和并发症管理,患者实现缓解,并在七年的随访期内一直无病生存。该病例突出了PCL的诊断和治疗挑战,尤其是与免疫性血小板减少症和疑似胸骨骨髓炎相关时,强调了多学科方法的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/58f8/11787818/2f8c74d40a7b/cureus-0017-00000076864-i01.jpg

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