Primary lymphoma of the heart: difficulties in diagnosis and treatment


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Abstract

Primary lymphoma of the heart (non-Hodgkin's lymphoma primarily of B-cells affecting first the heart and pericardium) is a rare disease which accounts for 1.3-2.0% of all primary tumors of the heart. A case is reported of a 43-year-old male patient with a cardioverter-defibrillator implanted at the age of 38 years for management of ventricular tachycardia paroxysms and AB-block of the second-third degree. The patient also had hypertrophic cardiomyopathy, moderate pressure gradient on the pulmonary artery valve and pericardial effusion. Later he had two cardiac tamponades (serous punctuate). From the age of 42 years breathlessness, right ventricular wall thickness, right heart pressure and pulmonary artery pressure aggravated. The patient has undergone ballon plastic surgery of the pulmonary artery valve. At the age of 43 computed tomography detected massive tumor of the heart and mediastinum first diagnosed as sarcoma but later specified as lymphoma. Endobronchial biopsy specimens contained the tissue of diffuse large B-cell lymphoma, the liver and lymph nodes were also involved. After the first course of effective polychemotherapy (CHOP) the patient died of mesenterial thrombosis. Diagnostic difficulties and problems of treatment policy are discussed.

About the authors

Ol'ga Vladimirovna Blagova

Email: blagovao@mail.ru

Aleksandr Viktorovich Nedostup

Email: avnedostup@mail.ru

Sergey Leonidovich Dzemeshkevich

Valentin Evgen'evich Sinitsyn

Vsevolod Parisovich Sedov

Nina Vladimirovna Gagarina

Vladimir Dmitrievich Parshin

S S Chernyy

Marina Vladimirovna Noskova

Mariya Pavlovna Troitskaya

O V Blagova

I.M. Sechenov State First Moscow Medical University

I.M. Sechenov State First Moscow Medical University

A V Nedostup

I.M. Sechenov State First Moscow Medical University

I.M. Sechenov State First Moscow Medical University

S L Dzemeshkevich

B.V. Petrovsky Russian Research Center for Surgery

B.V. Petrovsky Russian Research Center for Surgery

V E Sinitsyn

Therapeutic and Rehabilitation Center

Therapeutic and Rehabilitation Center

V P Sedov

I.M. Sechenov State First Moscow Medical University

I.M. Sechenov State First Moscow Medical University

N V Gagarina

I.M. Sechenov State First Moscow Medical University

I.M. Sechenov State First Moscow Medical University

V D Parshin

B.V. Petrovsky Russian Research Center for Surgery

B.V. Petrovsky Russian Research Center for Surgery

S S Cherny

B.V. Petrovsky Russian Research Center for Surgery

B.V. Petrovsky Russian Research Center for Surgery

M V Noskova

A.N. Bakulev Research Center for Cardiovascular Surgery

A.N. Bakulev Research Center for Cardiovascular Surgery

M P Troitskaya

I.M. Sechenov State First Moscow Medical University

I.M. Sechenov State First Moscow Medical University

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