Littman Dalia, Lovett Jessica, Adelsheimer Andrew, Bloom Michelle, Kaminetzky David, Skolnick Adam H
Department of Internal Medicine, NYU Grossman School of Medicine, New York, New York, USA.
Leon H. Charney Division of Cardiology, NYU Grossman School of Medicine, New York, New York, USA.
JACC Case Rep. 2025 Jul 9;30(18):103950. doi: 10.1016/j.jaccas.2025.103950.
Extrinsic compression of the pulmonary artery (PA) has been described with mediastinal and other thoracic masses. This compression can lead to acquired pulmonic stenosis and pulmonary hypertension.
A 27-year-old woman was diagnosed with Hodgkin lymphoma with a mediastinal mass compressing her PA leading to severe pulmonary hypertension, without hemodynamic compromise. She was treated with chemotherapy and had rapid resolution of the pulmonary artery compression on subsequent transthoracic echocardiogram 1 month after starting treatment.
The current literature on the rare entity of extrinsic PA compression includes cases of surgical or percutaneous intervention to relieve compression and cases with resolution of compression based on changes in physical examination or transthoracic echocardiogram several months after initial diagnosis. This case is novel in reporting echocardiographic evidence of complete resolution of PA compression within 1 month of treatment without invasive intervention.
TAKE-HOME MESSAGES: Pulmonary hypertension secondary to extrinsic PA compression from a mediastinal tumor is rare, but this case demonstrates that it may completely and rapidly resolve after initiation of chemotherapy. Short-interval follow-up echocardiography is helpful to reassess the degree of pulmonary hypertension after treatment.
肺动脉（PA）的外在压迫已在纵隔及其他胸部肿块中有所描述。这种压迫可导致获得性肺动脉狭窄和肺动脉高压。
一名27岁女性被诊断为霍奇金淋巴瘤，纵隔肿块压迫其肺动脉，导致严重肺动脉高压，但无血流动力学损害。她接受了化疗，在开始治疗1个月后的后续经胸超声心动图检查中，肺动脉压迫迅速缓解。
目前关于罕见的外在性肺动脉压迫的文献包括手术或经皮干预以缓解压迫的病例，以及在初始诊断数月后基于体格检查或经胸超声心动图变化而压迫缓解的病例。本病例的新颖之处在于报告了在无侵入性干预的情况下，治疗1个月内肺动脉压迫完全缓解的超声心动图证据。
纵隔肿瘤导致的外在性肺动脉压迫继发的肺动脉高压很少见，但本病例表明化疗开始后可能会完全且迅速地缓解。短间隔的随访超声心动图有助于治疗后重新评估肺动脉高压的程度。
