Case study-based systematic review of literature on lymphoma-associated cardiac tamponade

Abstract

This study aimed to compile all the relevant studies of patients presenting with pericardial tamponade before or after diagnosis of lymphoma, describe the clinical presentations of patients with lymphoma and cardiac tamponade, and assess the difference in overall survival based on the timing of cardiac tamponade diagnosis. A comprehensive search strategy was conducted in the following databases: PubMed and Cochrane Library, using the following keywords: Lymphoma AND Cardiac Tamponade. The criteria for eligibility included cases with a confirmed diagnosis of lymphoma and cardiac tamponade, human studies, and publications in English language. The statistical analysis was performed using IBM Statistical Package for Social Sciences (SPSS) version 20. We included 48 research articles ( n = 52 cases) with adequate reporting of measured outcomes. The median age of the patients was 52 (9–94) years. Only 6 patients were noted to have primary cardiac lymphoma, while the majority of cases were considered to have secondary cardiac lymphoma (88.5%). According to the data on the type of lymphoma reported through cytology and immunohistochemistry, 49 patients were diagnosed with non-Hodgkin lymphoma, and of these cases the most common subtype was large B-cell lymphoma (42.9%). Overall, the average duration of illness was 14 ± 23 days. A total of 13 patients had distant heart sounds, 12 cases were noted to be hypotensive, and 13 subjects were found to have increased jugular venous pressure. Our retrospective study demonstrated that most patients presented with pericardial tamponade after lymphoma diagnosis, and those were mostly secondary cardiac lymphoma of the non-Hodgkin type with large B-cell as the most common subtype. Dyspnoea, oedema, and constitutional symptoms were the most common presenting signs. The median overall survival of patients with lymphoma and cardiac tamponade is 4 months, with no significant difference in mortality in the presentation timing before and after the diagnosis of lymphoma.

Massive pericardial effusion as the first manifestation of childhood non‐Hodgkin's lymphoma: A case report

“…One of the frequent and serious manifestations of advanced malignancies is pericardial involvement, which includes various degrees such as pericarditis, pericardial effusion, pericardial tamponade, and constrictive pericarditis. 4 Symptomatic effusion mostly presents with tachycardia, dyspnea (our patient's chief complaint), and echocardiographic characteristics of right heart failure, but it can also occur asymptomatically. 5 , 6 It needs special attention particularly during the Era of the coronavirus (COVID‐19) pandemic, which most of these symptoms mimic the SARS‐CoV‐2 infection and also suffering from COVID‐19 may alter the prognosis of patients with malignancies, 7 , 8 and those patients need special attention.…”

“…Other complications, such as infections and autoimmune diseases, can also cause pericardial effusion in these patients. 4 , 10 The typical findings on electrocardiogram are sinus tachycardia and low voltage defined as maximum QRS amplitude <0.5 mV in the limb leads. New‐onset atrial fibrillation can be present.…”

“…On the contrary, malignancy involving the pericardium is usually a late secondary feature. 16 In a case study‐based systematic review on lymphoma‐associated cardiac tamponade, Shareef et al 4 evaluated 52 cases aged 9–95 (median 52), out of which 49 patients had non‐Hodgkin lymphoma, and observed that most of these patients were diagnosed with lymphoma prior to hospital presentation (80.8%). They also reported that the median overall survival of patients with lymphoma and cardiac tamponade is 4 months, and there is no significant difference between lymphoma diagnosis before or after this complication.…”

“…2 Pericardial effusion, which is the accumulation of fluid in the pericardial sac, is commonly associated with significant decrease in patient survival and may lead to grave consequences such as tamponade, cardiovascular collapse, and death. 3,4 Here, we present a case of this complication as the first manifestation of mediastinal lymphoma.…”

Massive Pericardial Effusion as The First Manifestation of Childhood Non-Hodgkin’s Lymphoma: A Case Report

“…Pericardial effusions in cancer patients can also be triggered by chemotherapy and radiotherapy. Other complications like infections and autoimmune diseases, can also cause pericardial effusion in these patients (4,7). The typical findings on electrocardiogram are sinus tachycardia and low voltage defined as maximum QRS amplitude <0.5 mV in the limb leads.…”