Fulminant primary cardiac lymphoma with sudden cardiac death: A case report and brief review

Primary cardiac lymphoma (PCL) is very rare, with the variable clinical manifestations potentially leading to a delayed diagnosis. PCL is usually detected incidentally through image studies, whereas the diagnosis can be confirmed via analysis of pericardial effusion, endomyocardial biopsy tissue, or...

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Bibliographic Details
Published in:Journal of the Formosan Medical Association 2018-10, Vol.117 (10), p.939-943
Main Authors: Cheng, Jen-Fang, Lee, Sze-Hwei, Hsu, Ron-Bin, Yu, Shan-Chi, Shun, Chia-Tung, Huang, Pang-Shuo, Chen, Ying-Hsien, Lee, Chii-Ming
Format: Article
Language:English
Subjects:
Cardiac
Death
Death, Sudden, Cardiac - etiology
Diagnosis, Differential
Echocardiography
Fatal Outcome
Heart neoplasms
Heart Neoplasms - diagnosis
Heart Neoplasms - pathology
Heart Neoplasms - surgery
Hemophagocytosis
Humans
Lymphoma
Lymphoma - diagnosis
Lymphoma - pathology
Lymphoma - surgery
Male
Middle Aged
Myocardium - pathology
Radiography, Thoracic
Risk Management
Sudden
Tomography, X-Ray Computed
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Summary:Primary cardiac lymphoma (PCL) is very rare, with the variable clinical manifestations potentially leading to a delayed diagnosis. PCL is usually detected incidentally through image studies, whereas the diagnosis can be confirmed via analysis of pericardial effusion, endomyocardial biopsy tissue, or surgical specimens. Although no standard therapy has been established for PCL, without treatment, the prognosis is grave, with the estimated overall survival being approximately 1 year. We report a difficult diagnosis and complicated case of fulminant PCL, which is the first comprehensively reported case of PCL with secondary hemophagocytosis. A man presented with progressive dyspnea for 3 weeks, and then sudden cardiac death with ventricular fibrillation occurred. After resuscitation, echocardiography revealed a thickened left ventricular wall and severe mitral regurgitation, and computed tomography showed a right atrial mass with diffuse myocardial lesions. PCL was confirmed through a pathological analysis of specimens collected during mitral valvuloplasty, which also implied extensive myocardial involvement. Bone marrow biopsy demonstrated no evidence of lymphoma involvement, but secondary hemophagocytosis was noted. Despite aggressive chemotherapy, the patient died of sepsis with multiorgan failure 26 days after the operation.
ISSN:0929-6646
1876-0821
DOI:10.1016/j.jfma.2018.03.011