PDF(Pubmed)
Abstract：
UNASSIGNED: Primary cardiac lymphoma is an extremely rare malignancy involving the heart and pericardium. It is a disease that most commonly effects the right atrium and right ventricle. Left untreated it carries a very poor prognosis. Recent advancements in therapy including early recognition and initiation of chemotherapy has led to improved survival.
UNASSIGNED: A 78 year old female presented with weight loss, abdominal pain and distension. An ultrasound abdomen pre admission showed abdominal ascites. An echocardiogram performed during admission showed a large pericardial effusion with asymmetrical increase in left ventricular wall thickness and a new left atrial mass. Pericardial fluid analysis led to the diagnosis of diffuse large B cell non-Hodgkin\'s lymphoma. Positron Emission Tomography CT (PET-CT) shows avid fluorodeoxyglucose (FDG) uptake in cardiac muscle. Prompt treatment was initiated with a chemotherapy regimen involving Rituximab, Cyclophosphamide, doxorubicin, vincristine, and prednisolone (R-CHOP). An echocardiogram 3 months post initiation of treatment showed resolution of the pericardial effusion and left atrial mass as well as an improvement in left ventricular wall thickness. A PET-CT following completion of treatment showed complete metabolic response.
UNASSIGNED: The diagnosis of primary cardiac lymphoma is uncommon and the presence of left rather than right heart involvement is rarer still. Multimodality imaging is key in diagnosis. Early recognition and treatment is vital in improving associated morbidity and mortality.
UNASSIGNED: A 78 year old female presented with weight loss, abdominal pain and distension. An ultrasound abdomen pre admission showed abdominal ascites. An echocardiogram performed during admission showed a large pericardial effusion with asymmetrical increase in left ventricular wall thickness and a new left atrial mass. Pericardial fluid analysis led to the diagnosis of diffuse large B cell non-Hodgkin\'s lymphoma. Positron Emission Tomography CT (PET-CT) shows avid fluorodeoxyglucose (FDG) uptake in cardiac muscle. Prompt treatment was initiated with a chemotherapy regimen involving Rituximab, Cyclophosphamide, doxorubicin, vincristine, and prednisolone (R-CHOP). An echocardiogram 3 months post initiation of treatment showed resolution of the pericardial effusion and left atrial mass as well as an improvement in left ventricular wall thickness. A PET-CT following completion of treatment showed complete metabolic response.
UNASSIGNED: The diagnosis of primary cardiac lymphoma is uncommon and the presence of left rather than right heart involvement is rarer still. Multimodality imaging is key in diagnosis. Early recognition and treatment is vital in improving associated morbidity and mortality.
摘要：
■原发性心脏淋巴瘤是一种极其罕见的恶性肿瘤，涉及心脏和心包。它是最常见的影响右心房和右心室的疾病。如果不及时治疗，预后非常差。包括早期识别和开始化疗在内的疗法的最新进展导致了生存率的提高。
■一位78岁的女性出现体重减轻，腹痛和腹胀。入院前腹部超声显示腹水。入院期间进行的超声心动图显示大量心包积液，左心室壁厚度不对称增加，新的左心房肿块。心包液分析可诊断为弥漫性大B细胞非霍奇金淋巴瘤。正电子发射断层扫描CT（PET-CT）显示心肌中的氟脱氧葡萄糖（FDG）摄取。采用利妥昔单抗的化疗方案开始及时治疗，环磷酰胺,阿霉素,长春新碱,和泼尼松龙（R-CHOP）。治疗开始后3个月的超声心动图显示心包积液和左心房质量的消退以及左心室壁厚度的改善。完成治疗后的PET-CT显示完全代谢反应。
■原发性心脏淋巴瘤的诊断并不常见，左心脏受累而不是右心脏受累的情况仍然很少见。多模态成像是诊断的关键。早期识别和治疗对于改善相关的发病率和死亡率至关重要。
■一位78岁的女性出现体重减轻，腹痛和腹胀。入院前腹部超声显示腹水。入院期间进行的超声心动图显示大量心包积液，左心室壁厚度不对称增加，新的左心房肿块。心包液分析可诊断为弥漫性大B细胞非霍奇金淋巴瘤。正电子发射断层扫描CT（PET-CT）显示心肌中的氟脱氧葡萄糖（FDG）摄取。采用利妥昔单抗的化疗方案开始及时治疗，环磷酰胺,阿霉素,长春新碱,和泼尼松龙（R-CHOP）。治疗开始后3个月的超声心动图显示心包积液和左心房质量的消退以及左心室壁厚度的改善。完成治疗后的PET-CT显示完全代谢反应。
■原发性心脏淋巴瘤的诊断并不常见，左心脏受累而不是右心脏受累的情况仍然很少见。多模态成像是诊断的关键。早期识别和治疗对于改善相关的发病率和死亡率至关重要。
