Abstract：
A 65-year-old man with previous history of smoking, controlled HIV infection, treated hepatitis B infection, and type III cryoglobulinemia, was admitted due to right heart failure symptoms and significant weight loss. Despite being haemodynamically stable, he had periods of 1:1 conduction atrial flutter and presented with respiratory alkalosis and metabolic acidosis, as well as acute kidney and hepatic dysfunction, elevated D-dimer and cardiac markers. He underwent imaging with chest computed tomography and echocardiogram that confirmed pulmonary embolism and most notably revealed a significant sized cardiac mass causing almost complete obstruction of the right chambers, with no cleavage plane with the myocardial walls and tricuspid valve. Cardiac magnetic resonance was highly suggestive of malignancy. Cardiac surgery for mass excision and endomyocardial biopsy for diagnosis were considered, but the patient died with obstructive shock unresponsive to medical treatment. The autopsy revealed a primary unspecified diffuse large B-cell lymphoma.
摘要：
一名有吸烟史的65岁男子，控制艾滋病毒感染，治疗乙型肝炎感染，和III型冷球蛋白血症,由于右心衰竭症状和明显的体重减轻而入院。尽管血液动力学稳定，他有1:1传导房扑，并表现为呼吸性碱中毒和代谢性酸中毒，以及急性肾和肝功能障碍，D-二聚体和心脏标志物升高。他接受了胸部计算机断层扫描和超声心动图的成像，证实了肺栓塞，最值得注意的是发现了一个巨大的心脏肿块，导致右腔几乎完全阻塞。与心肌壁和三尖瓣没有裂开平面。心脏磁共振高度怀疑恶性肿瘤。考虑了用于肿块切除的心脏手术和用于诊断的心内膜活检，但是病人死于阻塞性休克，对药物治疗无反应。尸检显示原发性未指明的弥漫性大B细胞淋巴瘤。
