Du Yadan, Tian Yuting, Chen Yawen, Cheng Shuaihua, Gao Jianping
Department of Surgical Oncology, Gansu Provincial Hospital, Lanzhou, China.
The First School of Clinical Medicine, Gansu University of Chinese Medicine, Lanzhou, China.
Front Oncol. 2025 Jun 11;15:1531668. doi: 10.3389/fonc.2025.1531668. eCollection 2025.
Diffuse large B-cell lymphoma (DLBCL) is the most prevalent type of aggressive lymphoma, commonly spreading to sites such as the lymph nodes, spleen, bone marrow, liver, lungs, and central nervous system. However, metastasis to the heart and ovaries is relatively uncommon.
A 63-year-old woman visited the hospital with abdominal pain and bloating, but showed none of the typical signs of lymphoma. Imaging scans revealed abnormal masses in both the pericardium and ovaries. A biopsy confirmed it was DLBCL, presenting in the rare form of simultaneous spread to the heart lining and ovaries. During the course of illness, she also developed atrial arrhythmia. Doctors adopted a phased treatment approach: four cycles of R-CEOD chemotherapy led to a noticeable reduction in the heart tumor and improvement in her heart rhythm. This was followed by four cycles of R-CHOP, which further shrank the cardiac lesion and cleared the abdominal tumors completely. The treatment was well tolerated, and at a three-month follow-up, there was no sign of recurrence. Her heart function remained stable, with a left ventricular ejection fraction (LVEF) of 60%.
This case highlights the importance of early detection of atypical metastases in DLBCL through a combination of various imaging and pathological tests. Additionally, personalized treatment strategies may contribute to better patient outcomes.
弥漫性大B细胞淋巴瘤（DLBCL）是侵袭性淋巴瘤中最常见的类型，通常会扩散至淋巴结、脾脏、骨髓、肝脏、肺和中枢神经系统等部位。然而，转移至心脏和卵巢相对少见。
一名63岁女性因腹痛和腹胀就诊于医院，但未表现出淋巴瘤的典型症状。影像学扫描显示心包和卵巢均有异常肿块。活检证实为DLBCL，以同时扩散至心脏内膜和卵巢的罕见形式呈现。在病程中，她还出现了房性心律失常。医生采用了分阶段治疗方法：四个周期的R-CEOD化疗使心脏肿瘤明显缩小，心律得到改善。随后进行了四个周期的R-CHOP治疗，进一步缩小了心脏病变并完全清除了腹部肿瘤。治疗耐受性良好，在三个月的随访中，没有复发迹象。她的心脏功能保持稳定，左心室射血分数（LVEF）为60%。
本病例强调了通过多种影像学和病理检查相结合早期发现DLBCL非典型转移的重要性。此外，个性化治疗策略可能有助于改善患者预后。
