Extrinsic pulmonary stenosis in primary mediastinal B‐cellular lymphoma

Abstract

We describe the case of a 34-year-old man with a history of asthenia and excessive fatigability. Transthoracic echocardiography showed a mass in the right ventricular outflow tract with a peak systolic gradient of 52 mmHg. Contrast-enhanced CT confirmed the presence of a lobulated mass, which extensively filled the anterior mediastinum, infiltrating the pulmonary artery trunk up to occupying the right ventricular outflow tract. CT-guided biopsy revealed primary mediastinal B-cellular lymphoma. The patient underwent chemotherapy, achieving complete remission of the disease at the 12-month follow-up, while the gradient across the pulmonary artery dropped from 52 mmHg to 14 mmHg.

Early diagnosis of lymphoma utilising Doppler pulmonary artery flow imaging

“…In the United States and England, the incidence of diffuse large B-cell lymphoma is approximately seven cases per 100,000 persons per year. 5 Extrinsic compression of the great vessels by a mediastinal mass is not commonly reported in the literature, [6][7][8] and this case is the first to demonstrate SVC compression by the lymphoma mass detected with echocardiogram and associated symptomatic palpitations. 1,3 Patients with DLBCL typically present with a rapidly enlarging symptomatic mass, most usually nodal enlargement in the neck, abdomen or mediastinum.…”

“…4 Extra-nodal lymphomatous infiltration of anatomic sites is common and can involve the stomach, spleen, central nervous system, lung, bone and skin. 5 Extrinsic compression of the great vessels by a mediastinal mass is not commonly reported in the literature, [6][7][8] and this case is the first to demonstrate SVC compression by the lymphoma mass detected with echocardiogram and associated symptomatic palpitations. The International Prognostic Index (IPI) and its variants are the main prognostic tools used in determining long-term prognosis in patients with DLBCL.…”

Acquired Pulmonic Stenosis Due to a Compressing Intrathoracic Abscess in a Thoroughbred Yearling

“…Moreover, there are no reports in the veterinary literature describing cardiac function after relieving right ventricular outflow tract compression. However, reports from human literature describe good outcomes with normalized cardiac parameters after medical or surgical removal of mediastinal neoplasms causing extrinsic pulmonic stenosis [7][8][9].…”

“…Extrinsic pulmonic stenosis due to cranial thoracic neoplasia has been described in the human literature [5][6][7][8][9]. Cranial thoracic abscesses may arise as a sequel to infections such as pneumonia, pulmonary abscesses, pericarditis, or pleuropneumonia and can result in cardiac compression depending on localization [10,11].…”

Extension to the heart of metastatic lung cancer presenting as acute neurological syndrome: The key role of echocardiography

“…Particularly, echocardiography is helpful for LA masses differential diagnosis, including primary or secondary cardiac tumors,[ 6 ] infective endocarditis (IE)[ 7 ] and thrombi. [ 8 9 10 ] Despite, IE may be excluded on the basis of medical history and clinical data, echocardiography is anyway an important tool providing unique diagnostic elements.…”