Endovascular Treatment of Symptomatic Thoracic Aneurysm Due to Periaortic Lymphoma

Abstract

An aggressive periaortic lymphoma could very rarely invade the aortic wall. We present a unique case of a patient with symptomatic thoracic aneurysm and imminent rupture due to the periaortic lymphoma, in which endovascular treatment using stent graft was applied. After stabilization of the aorta and histological confirmation of aggressive B-cell lymphoma by computed tomography-guided biopsy, the antilymphoma therapy was initiated. Despite the full treatment, the patient died 12 months later.

Primary Lymphoma Presenting in an Ascending Aortic Aneurysm: A Case Report

“…Thoracic aortic aneurysms associated with SLL have been previously described in the descending thoracic aorta. [1][2][3][4][5] To our knowledge, the association of a lymphoma with an ascending aortic aneurysm is novel. The extension of the aneurysm into the proximal aortic arch adds to the complexity of this case.…”

“…Lymphoma associated with an aneurysm of the thoracic aorta is a rare occurrence. Few cases have been described and locations of the aneurysm are primarily confined to the descending thoracic aorta [1][2][3][4][5] or the aortic arch. 6 Small lymphocytic lymphoma (SLL) is a malignancy of B-lymphocytes that may present with constitutional symptoms and adenopathy.…”

A Case of Periaortic Lymphoma Mimicking Complicated Type B Acute Aortic Dissection: A Pitfall in the Endovascular Surgery Era

“…Yiu et al 6) reported a case in which a positron emission tomography-CT (PET-CT) scan was performed because of persistent backache despite complete endovascular treatment. Raupach et al 7) reported a case in which the follow-up CT showed progressive enlargement of a circumferential periaortic hypodense mass, which had been investigated after the patient presented with fatigue and loss of weight. In the former reports, periaortic malignant lymphoma was suspected due to the unusual clinical symptoms.…”

Emergence of a lymphoma imitating an infectious infiltration surrounding the infrarenal aorta after EVAR

“…In 2002, Williamson et al published a case of a ruptured aneurysm of the abdominal aorta and iliac arteries by an invasive lymphoma, which was treated by the implantation of a bifurcation stent-graft [8]. Other publications deal with endovascular treatment of patients with a periaortic lymphoma that mimics a mycotic aneurysm of the abdominal aorta in the first case, and of the thoracic aorta in the second [15,16].…”