Secondary Cardiac T-Cell Lymphoma Presenting with Syncope and Refractory Complete Atrioventricular Block: A Case Report
Cutaneous T-cell lymphomas constitute a rare category of non-Hodgkin lymphomas, which may involve the heart in the timeline of their natural course as an infrequent picture with a poor prognosis. Syncope, either due to outflow obstruction or conduction block, is also an uncommon presentation of cardiac metastasis. We herein describe a 35-year-old man, who presented with weight loss, dyspnea of 6 months’ duration, an indolent skin ulcer in the left flank, lower limb deep vein thrombosis (DVT), and recurrent syncope. He underwent implantation of a permanent pacemaker due to a complete heart block and received anticoagulants for the DVT. Skin biopsy demonstrated a T-cell lymphoma. The syncopal episodes ceased thereafter. Echocardiography and computed tomography scan revealed cardiac metastasis, which responded to systemic chemotherapy. In the first follow-up visit after 3 months, he was still pacemaker-dependent. However, the DVT was partially resolved, and the symptoms had disappeared.
2. O'Mahony D, Peikarz RL, Bandettini WP, Arai AE, Wilson WH, Bates SE. Cardiac involvement with lymphoma: a review of the literature. Clin Lymphoma Myeloma 2008;8:249-252.
3. Servitje O, Limón A, Blanco A, Carmona M, Serrano T, Romagosa V, Gallardo F, García J, Peyrí J. Cardiac involvement and molecular staging in a fatal case of mycosis fungoides. Br J Dermatol 1999;141:531-535.
4. Criscione VD, Weinstock MA. Incidence of cutaneous T-cell lymphoma in the United States, 1973-2002. Arch Dermatol 2007;143:854-859.
5. Girardi M, Heald PW, Wilson LD. The pathogenesis of mycosis fungoides. N Engl J Med 2004;350:1978-1988.
6. Grebenc ML, Rosado de Christenson ML, Burke AP, Green CE, Galvin JR. Primary cardiac and pericardial neoplasms: radiologic-pathologic correlation. Radiographics 2000;20:1073-1103.
7. Dellas C, Chapuy B, Schweyer S, Hasenfuß G, Hünlich M. A rare cause of sudden cardiac arrest: primary cardiac lymphoma. Clin Res Cardiol 2009;98:509-511.
8. Antoniades L, Eftychiou C, Petrou PM, Bagatzounis A, Minas M. Primary cardiac lymphoma: case report and brief review of the literature. Echocardiography 2009;26:214-219.
9. Cho SW, Kang YJ, Kim TH, Cho SK, Hwang MW, Chang W, Rhee KJ, Kim BO, Goh CW, Park KM, Kim JH, Byun YS, Yuh YJ. Primary cardiac lymphoma presenting with atrioventricular block. Korean Circ J 2010;40:94-98.
10. Cucunato M, Cannavà G, Currò A. Complete atrioventricular block can be a long-term complication of radiation therapy. Int J Cardiol 2015;187:676-677.
11. Rudzinski T, Ciesielczyk M, Religa W, Bednarkiewicz Z, Krzeminska-Pakula M. Doxorubicin-induced ventricular arrhythmia treated by implantation of an automatic cardioverter-defibrillator. Europace 2007;9:278-280.
|Issue||Vol 15 No 4 (2020): J Teh Univ Heart Ctr|
|Lymphoma; T-cell Syncope Neoplasm metastasis Atrioventricular block Consolidation chemotherapy Echocardiography|
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