Complete regression of myocardial involvement associated with lymphoma following chemotherapy

Cardiac involvement as an initial presentation of malignant lymphoma is a rare occurrence.We describe the case of a 26 year old man who had initially been diagnosed with myocardial infiltration on an echocardiogram,presenting with a testicular mass and unilateral peripheral facial paralysis.On admis...

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Bibliographic Details
Published in:World journal of cardiology 2013-09, Vol.5 (9), p.364-368
Main Authors: Vinicki, Juan Pablo, Cianciulli, Tomás F, Farace, Gustavo A, Saccheri, María C, Lax, Jorge A, Kazelian, Lucía R, Wachs, Adolfo
Format: Article
Language:English
Subjects:
Case Report
Chemotherapy
Complete
Echocardiography
involvement
lymphoblastic
lymphoma
Myocardial
regression
T-cell
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Summary:Cardiac involvement as an initial presentation of malignant lymphoma is a rare occurrence.We describe the case of a 26 year old man who had initially been diagnosed with myocardial infiltration on an echocardiogram,presenting with a testicular mass and unilateral peripheral facial paralysis.On admission,electrocardiograms(ECG)revealed negative T-waves in all leads and ST-segment elevation in the inferior leads.On twodimensional echocardiography,there was infiltration of the pericardium with mild effusion,infiltrative thickening of the aortic walls,both atria and the interatrial septum and a mildly depressed systolic function of both ventricles.An axillary biopsy was performed and reported as a T-cell lymphoblastic lymphoma(T-LBL).Following the diagnosis and staging,chemotherapy was started.Twenty-two days after finishing the first cycle of chemotherapy,the ECG showed regression of T-wave changes in all leads and normalization of the ST-segment elevation in the inferior leads.A followup two-dimensional echo confirmed regression of the myocardial infiltration.This case report illustrates a lymphoma presenting with testicular mass,unilateral peripheral facial paralysis and myocardial involvement,and demonstrates that regression of infiltration can be achieved by intensive chemotherapy treatment.To our knowledge,there are no reported cases of T-LBL presenting as a testicular mass and unilateral peripheral facial paralysis,with complete regression of myocardial involvement.
ISSN:1949-8462
1949-8462
DOI:10.4330/wjc.v5.i9.364