Boey S, Fouda-Omgba F, Mirode A, Tribouilloy C, Quere J P, Lesbre J P
Service de cardiologie, CHU Amiens, hôpital Sud, Amiens.
Arch Mal Coeur Vaiss. 1997 Dec;90(12):1655-61.
The authors report a case of cardiac malignant non-Hodgkin lymphoma. The initial clinical presentation suggested recurrent angina in a patient who had undergone angioplasty of the left anterior descending artery two years previously. Echocardiography showed severe left ventricular dysfunction with apical and septal akinesia and also allowed visualisation of two oval masses in the right ventricle without dilatation of the right heart chambers. Transoesophageal echocardiography confirmed these abnormal echos which corresponded to tumour invasion of not only the right heart chambers but also the interatrial septum, the left atrial appendage and the descending thoracic aorta. Histological diagnosis of lymphoma was made from an excision biopsy of a mass in the calf muscle. The post-mortem examination confirmed the presence of a highly malignant T-cell non-Hodgkin lymphoma. The patient rapidly deteriorated and died during the first session of chemotherapy.
作者报告了一例心脏恶性非霍奇金淋巴瘤病例。该患者两年前接受了左前降支血管成形术,最初的临床表现提示为复发性心绞痛。超声心动图显示严重的左心室功能障碍,心尖和室间隔运动减弱,还能观察到右心室内有两个椭圆形肿块,而右心腔无扩张。经食管超声心动图证实了这些异常回声,这些回声不仅对应于肿瘤侵犯右心腔,还侵犯了房间隔、左心耳和胸降主动脉。通过对小腿肌肉肿块的切除活检做出了淋巴瘤的组织学诊断。尸检证实存在高度恶性的T细胞非霍奇金淋巴瘤。患者在第一次化疗期间病情迅速恶化并死亡。