Abstract：
A 78-year-old Japanese man presented to the emergency department with a sore throat and fever that worsened over 3 weeks. A tonsil biopsy led to the diagnosis of pleomorphic mantle cell lymphoma (MCL) that had infiltrated the right adrenal gland, inferior vena cava, and right atrium (RA). Although the patient\'s cardiac tumor had high mobility, his hemodynamic state was stable, and he did not present with fatal arrhythmia. Therefore, we first introduced chemotherapy. However, the patient developed recurrent pulmonary embolisms (PEs) and died after starting chemotherapy. An autopsy revealed that the MCL had invaded the large vessels, causing the PEs. Although the high mobility of cardiac tumors is known to increase the risk of PE in diffuse large B-cell lymphoma (DLBCL), optimal management of cardiac MCL remains to be elucidated owing to its rarity. To the best of our knowledge, this is the first report of cardiac MCL with posttreatment PE development in a Japanese patient. It is worth considering preventive surgery before treatment not only in DLBCL, but also in MCL based on the mobility of the cardiac tumors. Our case highlights the need for close communication between hematologists and cardiologists to treat cardiac MCL.
摘要：
一名78岁的日本男子因喉咙痛和发烧而出现在急诊室，并在3周内恶化。扁桃体活检导致诊断为浸润右肾上腺的多形性套细胞淋巴瘤（MCL），下腔静脉,右心房（RA）。虽然病人的心脏肿瘤有很高的活动性，他的血流动力学状态稳定,他没有出现致命的心律失常。因此,我们首先介绍了化疗。然而,患者出现复发性肺栓塞(PE),开始化疗后死亡.尸检显示MCL侵入了大血管，造成PE。尽管已知心脏肿瘤的高迁移率会增加弥漫性大B细胞淋巴瘤（DLBCL）中PE的风险，由于其稀有性，心脏MCL的最佳管理仍有待阐明。据我们所知,这是日本患者治疗后发生心脏MCL伴PE的首例报道.不仅在DLBCL中，在治疗前考虑预防性手术是值得的，而且在基于心脏肿瘤的移动性的MCL中。我们的案例强调了血液学家和心脏病专家之间需要密切沟通以治疗心脏MCL。
