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Rector G, Koh SJ, Tabbaa R. A Case of Isolated Cardiac Burkitt Lymphoma Causing Right-Sided Heart Failure. Tex Heart Inst J 2022; 49:488993. [PMID: 36472919 PMCID: PMC9809082 DOI: 10.14503/thij-21-7575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Primary cardiac tumors are rare, as the most common cause of cardiac masses is from metastatic disease. In this article, a unique case of isolated cardiac Burkitt lymphoma causing right-sided heart failure in a 70-year-old man who presented to the emergency department with abdominal distension and lower-extremity swelling is described. The right ventricular mass was initially identified via computed tomographic scans of the abdomen and pelvis. Further workup included transthoracic echocardiogram and cardiac magnetic resonance imaging that showed extension of the mass into the right atrium and pericardium. Staging imaging and bone marrow biopsy revealed no evidence of metastatic disease. Cytology of the peritoneal fluid and biopsy of the right ventricular mass confirmed Burkitt lymphoma. The cardiac mass substantially decreased in size and the right-sided heart failure resolved after the initiation of chemotherapy, which highlights the importance of prompt diagnosis and treatment of Burkitt lymphoma.
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Affiliation(s)
- Graham Rector
- Department of Internal Medicine, Baylor College of Medicine, Houston, Texas
| | - Stephanie J. Koh
- Section of Cardiology, Department of Internal Medicine, Baylor College of Medicine, Houston, Texas
| | - Rashed Tabbaa
- Section of Cardiology, Department of Internal Medicine, Baylor College of Medicine, Houston, Texas
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2
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Schmiester M, Tranter E, Lorusso A, Blaschke F, Geisel D, Bullinger L, Damm F, Na IK. Acute left ventricular insufficiency in a Burkitt Lymphoma patient with myocardial involvement and extensive local tumor cell lysis: a case report. BMC Cardiovasc Disord 2022; 22:31. [PMID: 35120455 PMCID: PMC8815241 DOI: 10.1186/s12872-022-02480-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 01/27/2022] [Indexed: 11/30/2022] Open
Abstract
Background Burkitt lymphoma (BL) is a rare disease with the sporadic variant accounting for less than 1% of adult non-Hodgkin lymphomas. BL usually presents with an abdominal bulk, but extranodal disease affecting the bone marrow and central nervous system is common. Cardiac manifestations, however, are exceedingly rare, with less than 30 cases reported in the literature. Case presentation We report on a 54-year-old male patient with a six week-long history of paranasal sinus swelling, fatigue and dyspnea on exertion. Stage IV sporadic BL with extensive lymphonodal and cardiovascular involvement was diagnosed. Manifestations included supra- and infradiaphragmatic lymphadenopathy as well as infiltration of the aortic root, the pericardium, the right atrium and the right ventricle. EBV-reactivation was detected, which is uncommon in the sporadic subtype. After initial full-dose chemotherapy with very good BL control, the patient developed acute, but fully reversible cardiac insufficiency. Myocardial lymphoma involvement receded completely during the following two therapy cycles, while cardiac function periodically deteriorated shortly after chemotherapy administration and quickly recovered thereafter. Interestingly, the decline in cardiac function lessened with decreasing myocardial lymphoma manifestation. Once the cardiovascular BL infiltration was resolved, cardiac function remained stable throughout further treatment. Following seven cycles of chemotherapy and mediastinal radiation, the patient is now in continued complete remission. Conclusions Although rare, cardiac involvement in BL can quickly become life-threatening due to rapid lymphoma doubling time and should therefore be considered at initial diagnosis. This case suggests an association between myocardial infiltration, chemotherapy associated tumor cell lysis and transient deterioration of cardiac function until the damage caused by the underlying lymphoma could be restored. While additional studies are needed to further elucidate the mechanisms of acute cardiac insufficiency due to lymphoma lysis in the infiltrated structures, prompt BL control and full recovery of the patient supports courageous treatment start despite extensive cardiovascular involvement.
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Affiliation(s)
- Maren Schmiester
- Department of Hematology, Oncology, and Tumor Immunology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
| | - Eva Tranter
- Department of Hematology, Oncology, and Tumor Immunology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Alessandro Lorusso
- Department of Hematology, Oncology, and Tumor Immunology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Florian Blaschke
- Department of Cardiology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Dominik Geisel
- Department of Radiology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Lars Bullinger
- Department of Hematology, Oncology, and Tumor Immunology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Frederik Damm
- Department of Hematology, Oncology, and Tumor Immunology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Il-Kang Na
- Department of Hematology, Oncology, and Tumor Immunology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
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3
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Hérnandez Jimenez CA, Schlie Villa W, Ordinola Navarro A. Cardiac Burkitt's lymphoma presenting with heart failure. QJM 2021; 114:589-590. [PMID: 33713134 DOI: 10.1093/qjmed/hcab053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Indexed: 11/14/2022] Open
Affiliation(s)
- C A Hérnandez Jimenez
- Department of Internal Medicine, Hospital de Especialidades "Dr. Antonio Fraga Mouret", Centro Médico Nacional La Raza del Instituto Mexicano del Seguro Social, Calle Seris y Zaachila, La Raza, 02990 Azcapotzalco, Mexico City, Mexico
| | - W Schlie Villa
- Department of Internal Medicine, Hospital de Especialidades "Dr. Antonio Fraga Mouret", Centro Médico Nacional La Raza del Instituto Mexicano del Seguro Social, Calle Seris y Zaachila, La Raza, 02990 Azcapotzalco, Mexico City, Mexico
| | - A Ordinola Navarro
- Department of Internal Medicine, Hospital de Especialidades "Dr. Antonio Fraga Mouret", Centro Médico Nacional La Raza del Instituto Mexicano del Seguro Social, Calle Seris y Zaachila, La Raza, 02990 Azcapotzalco, Mexico City, Mexico
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4
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Alfahadi MN, Malik FA, Almahlawi AS, Alhamdan WA. A rare case of the superior vena cava obstruction in a 16-year-old boy with Burkitt's lymphoma: A case report. J Taibah Univ Med Sci 2021; 16:465-469. [PMID: 34140876 PMCID: PMC8178627 DOI: 10.1016/j.jtumed.2020.12.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 12/19/2020] [Accepted: 12/21/2020] [Indexed: 11/24/2022] Open
Abstract
Burkitt's lymphoma (BL) is an aggressive non-Hodgkin B-cell lymphoma. Superior vena cava obstruction (SVCO) is considered a rare presentation of BL and it is usually associated with other types of non-Hodgkin lymphoma such as diffuse large-cell. We report a rare case of sporadic BL with SVCO in a 16-year-old boy with nasopharyngeal, mediastinal, and adrenal masses. The patient presented with a two-month history of left upper neck swelling that increased with time and was not associated with other symptoms. The patient tested positive for COVID-19 on the second day after admission. On examination, he had enlarged solitary lateral cervical and bilateral posterior auricular lymph nodes. There were no signs or symptoms of SVCO regardless of the findings suggested by the computed tomography of the chest. The patient was treated with hyper-CVAD chemotherapy and showed a remarkable resolution of the nasopharyngeal and mediastinal masses with a mild response of his adrenal mass. There were no complications detected during this patient's management.
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Affiliation(s)
- Mohammad N. Alfahadi
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, KSA
- Corresponding address: College of Medicine, King Saud bin Abdulaziz University for Health Sciences, P.O. Box 7535, Riyadh, 13225, KSA.
| | - Fatima A. Malik
- Division of Internal Medicine, Department of Medicine, King Abdulaziz Medical City, Ministry of National Guard – Health Affairs, Riyadh, KSA
| | - Alzahraa S. Almahlawi
- Division of Internal Medicine, Department of Medicine, King Abdulaziz Medical City, Ministry of National Guard – Health Affairs, Riyadh, KSA
| | - Wejdan A. Alhamdan
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, KSA
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5
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Khalid K, Faza N, Lakkis NM, Tabbaa R. Cardiac Involvement by Burkitt Lymphoma in a 49-Year-Old Man. Tex Heart Inst J 2020; 47:210-212. [PMID: 32997778 DOI: 10.14503/thij-17-6448] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Malignant metastases are among the most common cardiac masses. We report a rare case of cardiac involvement by Burkitt lymphoma in a 49-year-old man who presented with a 2-month history of dyspnea and palpitations. A transthoracic echocardiogram revealed 2 intracardiac masses in the right atrium (one of which partially encased the tricuspid valve), myocardial infiltration, and pericardial disease. Results of pleural fluid cytology and flow cytometry confirmed involvement by Burkitt lymphoma. Subsequent chemotherapy markedly reduced the intracardiac tumor burden and resolved the patient's presenting symptoms. Our case highlights the importance of cardiac imaging in diagnosing systemic illness, initiating early and appropriate treatment, and monitoring disease progression in patients with intracardiac Burkitt lymphoma.
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Affiliation(s)
- Kainat Khalid
- Section of Cardiology, Department of Internal Medicine, Baylor College of Medicine, One Baylor Plaza, Houston, Texas 77030
| | - Nadeen Faza
- Section of Cardiology, Department of Internal Medicine, Baylor College of Medicine, One Baylor Plaza, Houston, Texas 77030
| | - Nasser M Lakkis
- Section of Cardiology, Department of Internal Medicine, Baylor College of Medicine, One Baylor Plaza, Houston, Texas 77030
| | - Rashed Tabbaa
- Section of Cardiology, Department of Internal Medicine, Baylor College of Medicine, One Baylor Plaza, Houston, Texas 77030
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Rosas D, Yepes I, Tschanz J, Wariboko M, Sandoval-Sus JD. Epstein-Barr Virus: From Kissing Disease to Broken Heart. Cureus 2020; 12:e7704. [PMID: 32431983 PMCID: PMC7233509 DOI: 10.7759/cureus.7704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 04/17/2020] [Indexed: 11/05/2022] Open
Abstract
We present a case of a 59 year old female patient that presented with exertional chest pain and palpitations. A workup revealed an EKG with signs of right ventricular hypertrophy, a high Pro-BNP and 3 sets of negative troponin levels. A CT scan of the chest was negative for pulmonary embolism (PE) but revealed a nodular thickening of the atrial septum with right atrial extension encasing the right coronary artery. A CT scan of the abdomen and pelvis with IV contrast revealed several nodular foci scattered in the subcutaneous fat of the abdominal wall bilaterally. An initial transthoracic echocardiogram (TTE) revealed thickening of the interatrial septum with a mass protruding from the interatrial septum into the left atrium and a secondary pedunculated mass protruding from the interatrial septum into the right atrium with significant obstruction within the right atrium. An ultrasound-guided biopsy of the soft tissue nodule in the right anterior abdominal wall and subcutaneous tissue showed the classical starry sky appearance pattern confirmed later to be a Burkitt lymphoma. The patient received chemotherapy and follow up CT of the abdomen and pelvis reported resolution of the soft tissue density involving the partially visualized portions of the heart. Although rare, cardiac lymphomas should be considered in the differential diagnosis of patients with identified cardiac masses. As the initial presentation is usually composed by non-specific symptoms, a detailed clinical history can identify certain constitutional symptoms and a thorough physical exam can lead to the suspicion of cardiac structural pathology prompting the need for the appropriate chest imaging. Further characterization may need TTE or TEE which are more sensitive and specific due to the tri-dimensional and temporal quality of the imaging. Appropriate biopsy with pathology and molecular studies are of utmost importance in making an accurate diagnosis in order to select the best management for this highly aggressive malignancy.
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Affiliation(s)
- Daniel Rosas
- Internal Medicine, Memorial Healthcare, Sunrise, USA
| | - Isaac Yepes
- Internal Medicine, Memorial Hospital West Healthcare System, Pembroke Pines, USA
| | - Jacqueline Tschanz
- Internal Medicine, Memorial Hospital West Healthcare System, Pembroke Pines, USA
| | - Minaba Wariboko
- Cardiology, Memorial Hospital West Healthcare System, Pembroke Pines, USA
| | - Jose D Sandoval-Sus
- Malignant Hematology & Cellular Therapy, Moffitt Cancer Center at Memorial Healthcare System, Pembroke Pines, USA
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7
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Kalisz K, Alessandrino F, Beck R, Smith D, Kikano E, Ramaiya NH, Tirumani SH. An update on Burkitt lymphoma: a review of pathogenesis and multimodality imaging assessment of disease presentation, treatment response, and recurrence. Insights Imaging 2019; 10:56. [PMID: 31115699 PMCID: PMC6529494 DOI: 10.1186/s13244-019-0733-7] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Accepted: 03/13/2019] [Indexed: 12/12/2022] Open
Abstract
Burkitt lymphoma (BL) is a highly aggressive, rapidly growing B cell non-Hodgkin lymphoma, which manifests in several subtypes including sporadic, endemic, and immunodeficiency-associated forms. Pathologically, BL is classically characterized by translocations of chromosomes 8 and 14 resulting in upregulation of the c-myc protein transcription factor with upregulation of cell proliferation. BL affects nearly every organ system, most commonly the abdomen and pelvis in the sporadic form. Imaging using a multimodality approach plays a crucial role in the management of BL from diagnosis, staging, and evaluation of treatment response to therapy-related complications with ultrasound, computed tomography, magnetic resonance imaging, and positron emission tomography playing roles. In this article, we review the pathobiology and classification of BL, illustrate a multimodality imaging approach in evaluating common and uncommon sites of involvement within the trunk and head and neck, and review common therapies and treatment-related complications.
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Affiliation(s)
- Kevin Kalisz
- Department of Radiology, Duke University, Durham, NC, USA
| | - Francesco Alessandrino
- Department of Imaging, Dana Farber Cancer Institute, Harvard Medical School, 450 Brookline Avenue, Boston, MA, 02215, USA. .,Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
| | - Rose Beck
- Department of Pathology, UH Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, USA
| | - Daniel Smith
- Department of Radiology, UH Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, USA
| | - Elias Kikano
- Department of Radiology, UH Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, USA
| | - Nikhil H Ramaiya
- Department of Radiology, UH Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, USA
| | - Sree Harsha Tirumani
- Department of Imaging, Dana Farber Cancer Institute, Harvard Medical School, 450 Brookline Avenue, Boston, MA, 02215, USA.,Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.,Department of Radiology, UH Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, USA
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8
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Illésy L, Szabó RP, Kovács DÁ, Fedor R, Nemes B. Non-Hodgkin Lymphoma in a Kidney Transplant Patient: A Case Report. Transplant Proc 2019; 51:1286-1288. [PMID: 31101215 DOI: 10.1016/j.transproceed.2019.04.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Post-transplant lymphoproliferative disorders are a possible complication of kidney transplant due to chronic immunosuppressive therapy, and they can elevate the mortality rate. Furthermore, the type of clinical appearance has a wide range. We describe a case of a 38-year-old male recipient who developed post-transplant lymphoproliferative disorders and received successful treatment. The recipient had received a kidney with 1 HLA-B and 1 HLA-DR match, and the deceased donor allotransplant was performed successfully on December 9, 2012. The cause of kidney failure was membranoproliferative-glomerulonephritis proved by biopsy results. The induction therapy was antithymocyte globulin; the basic immunosuppressive therapy consisted of tacrolimus, steroid, and mycophenolate mofetil. After 2 months the patient had elevated serum creatinine level, and biopsy results revealed cellular rejection (Banff grade I). We applied steroid bolus therapy. After that the graft worked properly for 5 years, and the patient had no symptoms or complaints; then he had right lower abdomen pain. After urgent procedures (laboratory diagnostics, abdominal ultrasonography, computed tomography), we operated on the patient in a short time, and after a few weeks the fluorescence in situ hybridization confirmed the translocation of region C-myc; the diagnosis was diffuse large B-cell lymphoma. With the assistance of hematologists, the patient received adequate therapy. He was asymptomatic half a year after the rituximab with cyclophosphamide, vincristine, doxorubicin, methotrexate/ifosfamide, etoposide, and high-dose cytarabine protocol therapy; the lymphoma is in remission. Our case is worth presenting because immunosuppressive drugs can modify the clinical picture, complicating the diagnosis and delaying treatment.
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Affiliation(s)
- Lóránt Illésy
- Department of Transplantation, Institute of Surgery, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.
| | - Réka P Szabó
- Department of Transplantation, Institute of Surgery, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Dávid Ágoston Kovács
- Department of Transplantation, Institute of Surgery, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Roland Fedor
- Department of Transplantation, Institute of Surgery, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Balázs Nemes
- Department of Transplantation, Institute of Surgery, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
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9
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Primary Hepatic Burkitt Lymphoma in a Kidney Transplant Recipient. Case Rep Nephrol 2018; 2018:7425785. [PMID: 29862100 PMCID: PMC5971355 DOI: 10.1155/2018/7425785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Accepted: 03/29/2018] [Indexed: 11/19/2022] Open
Abstract
This is a case of a renal transplant recipient who developed a primary hepatic Burkitt lymphoma a few years after kidney transplantation. The past medical history of the patient was significant for anti-HCV positivity with liver histopathology showing minimal changes of grades 0 and 1, stage 0. She received a graft from a deceased donor, with rabbit antithymocyte globulin and methyl-prednisolone, as induction therapy, and was maintained on azathioprine, cyclosporine, and low dose methyl-prednisolone with normal renal function. Four years after KTx she presented with fatigue, hepatomegaly, and impaired liver function and the workup revealed multiple, variable-sized, low density nodules in the liver, due to diffuse monotonous infiltration of highly malignant non-Hodgkin lymphoma of B-cells, which turned out to be a Burkitt lymphoma. Bone marrow biopsy and spinal fluid exam were free of lymphoma cells. At time of lymphoma diagnosis she was shown to be positive for Epstein-Barr virus polymerase chain reaction. She received aggressive chemotherapy but died due to sepsis, as a result of toxicity of therapy.
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Xu F, Xiao Z, Peng L, Qin C, Yang G, Gu J, Zuo Y. A Rare Case of Cardiac Calcified Amorphous Tumor: Multi-Modality Imaging Evaluation. AMERICAN JOURNAL OF CASE REPORTS 2018; 19:214-217. [PMID: 29483487 PMCID: PMC5841954 DOI: 10.12659/ajcr.907641] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Patient: Male, 47 Final Diagnosis: Cardiac calcified amorphous tumor Symptoms: Dizziness Medication: — Clinical Procedure: — Specialty: Cardiac Procedure
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Affiliation(s)
- Fei Xu
- Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China (mainland)
| | - Zhenghua Xiao
- Department of Cardiovascular Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China (mainland)
| | - Liqing Peng
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China (mainland)
| | - Chaoyi Qin
- Department of Cardiovascular Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China (mainland)
| | - Gang Yang
- Department of Medical Information and Engineering, School of Electrical Engineering and Information, Sichuan University, Chengdu, Sichuan, China (mainland)
| | - Jun Gu
- Department of Cardiovascular Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China (mainland)
| | - Yunxia Zuo
- Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China (mainland)
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Sarr SA, Gaye AM, Aw F, de Dieu Nzambaza J, Bodian M, Babaka K, Ndiaye MB, Kane A, Diao M, Ba SA. Obstructive Primary Cardiac T-Cell Lymphoma: A Case Report from Senegal. AMERICAN JOURNAL OF CASE REPORTS 2017; 18:281-285. [PMID: 28316327 PMCID: PMC5374889 DOI: 10.12659/ajcr.901455] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Cardiac lymphoma is a rare entity, defined by the non-extra cardiac location at diagnosis. CASE REPORT Our patient was a 32-year-old female with no particular medical history, who presented with right heart failure with recurrent ascites and pleural effusion. There was a progressive worsening exertional dyspnea. On admission, examination revealed an irregular tachycardia at 170 beats per minute (bpm) and congestive heart failure. The electrocardiogram scored full tachyarrhythmia by atrial fibrillation with an average ventricular rate of 179 cycles per minute. Doppler echocardiography showed dilatation and systolic dysfunction of the left ventricle. There were dilated atria. We noted a large mass in the right atrium, which was less mobile, heterogeneous, integral with the wall, and filling three quarters of the cavity. It clogged the tricuspid valve in diastole. CT scan showed a tissue process enhanced after contrast injection, occupying the predominant cavities in the right atrium and filling it. Its borders were irregular. The lesion was extended to the posterior mediastinum, in front of the vertebral axis. In addition, there was a thrombosis of the jugular vein and the inferior vena cava. There was no other tumor site noted. The patient died after presenting with cardiovascular shock associated with refractory right heart failure. Pathology examination confirmed T-cell lymphoma. CONCLUSIONS The primitive cardiac lymphoma is an entity of intra-cardiac masses. It is therefore to be considered even if the diagnosis is challenging.
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Affiliation(s)
- Simon Antoine Sarr
- Department of Cardiology, Teaching Hospital Aristide Le Dantec, Dakar, Senegal
| | - Abdou Majib Gaye
- Department of Anatomopathology, Teaching Hospital Aristide Le Dantec, Dakar, Senegal
| | - Fatou Aw
- Department of Cardiology, Teaching Hospital Aristide Le Dantec, Dakar, Senegal
| | | | - Malick Bodian
- Department of Cardiology, Teaching Hospital Aristide Le Dantec, Dakar, Senegal
| | - Kana Babaka
- Department of Cardiology, Teaching Hospital Aristide Le Dantec, Dakar, Senegal
| | | | - Adama Kane
- Department of Cardiology, Teaching Hospital Aristide Le Dantec, Dakar, Senegal
| | - Maboury Diao
- Department of Cardiology, Teaching Hospital Aristide Le Dantec, Dakar, Senegal
| | - Serigne Abdou Ba
- Department of Cardiology, Teaching Hospital Aristide Le Dantec, Dakar, Senegal
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