Nakchbandi I A, Day H J
Department of Medicine, Abington Memorial Hospital, PA, USA.
South Med J. 1997 May;90(5):539-43. doi: 10.1097/00007611-199705000-00016.
We report a case of primary cardiac lymphoma in a patient who was not infected with human immunodeficiency virus and had symptoms suggestive of upper gastrointestinal (GI) disease. Examination revealed no GI abnormalities. Echocardiography, prompted by sudden development of congestive heart failure, revealed a large right atrial mass. Cardiac biopsy followed by staging evaluation indicated primary cardiac non-Hodgkin's lymphoma. After chemotherapy was begun, the tumor shrunk and GI symptoms resolved, suggesting an etiologic relationship by a referred pain mechanism. Unusual features of our case include the initial predominance of GI symptoms and the circumstances that led to diagnosis antemortem. The case also underscores the importance of considering intrathoracic disease in patients with upper abdominal symptomatology.
我们报告一例原发性心脏淋巴瘤患者，该患者未感染人类免疫缺陷病毒，有提示上消化道（GI）疾病的症状。检查未发现胃肠道异常。因充血性心力衰竭突然发作而行超声心动图检查，发现右心房有一个大肿块。心脏活检及分期评估显示为原发性心脏非霍奇金淋巴瘤。化疗开始后，肿瘤缩小，胃肠道症状缓解，提示通过牵涉痛机制存在病因关系。我们病例的不寻常特征包括最初以胃肠道症状为主以及生前诊断的情况。该病例还强调了对上腹部有症状的患者考虑胸腔内疾病的重要性。
