Abstract
We report a case of primary cardiac lymphoma presenting as myopericarditis and rapidly
deteriorating into biventricular heart failure and ventricular arrhythmias. Computed
tomography and cardiac magnetic resonance (CMR) imaging showed extensive myocardial
infiltration with typical patterns on tissue characterization CMR images, raising
clinical suspicion. Diagnosis was confirmed by myocardial histologic examination.
Marked regression of tumor burden was apparent after 6 cycles of anthracycline-based
chemotherapy. This case illustrates that a high degree of suspicion for this rare
entity is mandated to institute timely treatment. Rapid tumor lysis may induce life-threatening
acute cardiac decompensation that requires intensive monitoring and support therapy.
Résumé
Nous signalons le cas d’un lymphome cardiaque primitif secondaire à une myopéricardite,
qui a rapidement évolué vers une insuffisance cardiaque biventriculaire et des arythmies
ventriculaires. Une tomodensitométrie et un examen d’imagerie par résonance magnétique
cardiaque ont montré une infiltration myocardique généralisée avec variations typiques
sur les images de la caractérisation des tissus éveillant des soupçons sur le plan
clinique. Le diagnostic a été confirmé par un examen histologique du myocarde. On
a observé une diminution marquée de la masse tumorale après 6 cycles de chimiothérapie
à base d’anthracycline. Ce cas montre qu’une suspicion élevée de cette maladie rare
exige l’instauration rapide d’un traitement. Puisqu’une lyse tumorale rapide peut
entraîner une décompensation cardiaque aiguë et peut-être mettre la vie en danger,
une surveillance étroite et l’administration d’un traitement de soutien sont de mise.
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References
- Pathological study of primary cardiac and pericardial tumours in a specialist UK Centre: surgical and autopsy series.Cardiovasc Pathol. 2010; 19: 343-352
- Primary cardiac lymphoma: B- and T-cell cases at a specialist UK centre.Ann Oncol. 2010; 21: 1041-1045
- MRI and CT appearances of cardiac tumours in adults.Clin Radiol. 2009; 64: 1214-1230
- Successful treatment of primary cardiac lymphoma by rituximab-CHOP and high-dose chemotherapy with autologous peripheral blood stem cell transplantation.Int J Hematol. 2007; 85: 264-266
Article info
Publication history
Published online: September 12, 2015
Accepted:
September 5,
2015
Received:
August 4,
2015
Footnotes
See page 931.e3 for disclosure information.
Identification
Copyright
© 2016 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.
