Mediastinal Lymphosarcoma Simulating Pericarditis

Abstract

A case of lymphosarcoma of the heart in a 10-year-old boy is presented. The clinical picture simulated a pericarditis. Prednisolone had a remarkably good temporary effect. Post-mortem examination showed a highly differentiated lymphosarcoma invading the pericardium and myocardium from a primary mediastinal localisation. Cytologic examination for malignant cells in the pericardial fluid must not be forgotten in a case of unexplained pericardial effusion.

Small Noncleaved Cell Lymphoma Presenting as a Massive Pericardial Effusion

“…1 However, pericardial effusion may also be the presenting manifestation of NHL; this situation is much rarer, with only 12 cases reported. [2][3][4][5][6][7][8][9][12][13][14] The majority (7/12) were either not diagnosed prior to death or not diagnosed from the pericardial fluid (PF); either the PF was not examined, was considered "unsuitable" or was interpreted only as "atypical" lymphoid cells. In the remaining 5 cases, 3 were diagnosed by routine cytologic examination alone, 1 was diagnosed with the aid of immunoperoxidase staining, and 1 also utilized fluorescent labeling with heavy chains, kappa and lambda by a slide method (Table 1).…”