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20 March 2017 : Case report  Senegal

Obstructive Primary Cardiac T-Cell Lymphoma: A Case Report from Senegal

Challenging differential diagnosis, Diagnostic / therapeutic accidents, Unusual setting of medical care, Rare disease

Simon Antoine Sarr1ABDEF*, Abdou Majib Gaye2BCD, Fatou Aw1ABD, Jean de Dieu Nzambaza1BDE, Malick Bodian1BCD, Kana Babaka1DEF, Mouhamadou Bamba Ndiaye1F, Adama Kane1F, Maboury Diao1F, Serigne Abdou Ba1AF

DOI: 10.12659/AJCR.901455

Am J Case Rep 2017; 18:281-285

Abstract

BACKGROUND: Cardiac lymphoma is a rare entity, defined by the non-extra cardiac location at diagnosis.

CASE REPORT: Our patient was a 32-year-old female with no particular medical history, who presented with right heart failure with recurrent ascites and pleural effusion. There was a progressive worsening exertional dyspnea. On admission, examination revealed an irregular tachycardia at 170 beats per minute (bpm) and congestive heart failure. The electrocardiogram scored full tachyarrhythmia by atrial fibrillation with an average ventricular rate of 179 cycles per minute. Doppler echocardiography showed dilatation and systolic dysfunction of the left ventricle. There were dilated atria. We noted a large mass in the right atrium, which was less mobile, heterogeneous, integral with the wall, and filling three quarters of the cavity. It clogged the tricuspid valve in diastole. CT scan showed a tissue process enhanced after contrast injection, occupying the predominant cavities in the right atrium and filling it. Its borders were irregular. The lesion was extended to the posterior mediastinum, in front of the vertebral axis. In addition, there was a thrombosis of the jugular vein and the inferior vena cava. There was no other tumor site noted. The patient died after presenting with cardiovascular shock associated with refractory right heart failure. Pathology examination confirmed T-cell lymphoma.

CONCLUSIONS: The primitive cardiac lymphoma is an entity of intra-cardiac masses. It is therefore to be considered even if the diagnosis is challenging.

Keywords: Echocardiography, Heart Failure, Heart Neoplasms, Lymphoma, T-Cell

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American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923