Non‐hodgkin's lymphoma of the heart in patients infected with human immunodeficiency virus

Abstract

A case of HIV‐associated cardiac non‐Hodgkin's lymphoma (NHL) is described, and the epidemiologic and clinicopathologic features of 21 cases previously reported in the literature are analyzed. All patients were homosexual males, and the cardiac NHL was the first acquired immune deficiency syndrome‐defining condition in the majority. Patients were referred with nonspecific clinical findings including dyspnea and tachycardia, but rapid progression of cardiac dysfunction was frequent after symptoms appeared. Echocardiography constitutes the most useful noninvasive procedure in the diagnosis of cardiac NHL. Most of the patients had disseminated disease at initial presentation; pathologically, the lymphomas were of B lymphocyte origin and of high‐grade subtypes. Prognosis of HIV‐associated cardiac NHL is generally poor, although clinical remission has been observed with combination chemotherapy. Cardiac lymphomas in HIV‐associated patients are typically high‐grade and often disseminate early. Although the prognosis is poor, patients in whom dissemination has not occurred could have longer survival under systemic chemotherapy.

Cardiovascular complications in the acquired immunodeficiency syndrome

“…Most are high-grade B-cell (small non-cleaved) Burkitt-like lymphomas, with the rest classified as diffuse large B cell lymphomas (in the REAL classification). Lymphomatous lesions may appear grossly as either discreet localized or more diffuse nodular to polypoid masses 11,48,49 . Most involve the pericardium, with variable myocardial infiltration 11,48,49 .There is little or no accompanying inflammation and necrosis.…”

“…Lymphomatous lesions may appear grossly as either discreet localized or more diffuse nodular to polypoid masses 11,48,49 . Most involve the pericardium, with variable myocardial infiltration 11,48,49 .There is little or no accompanying inflammation and necrosis. Prognosis of patients with HIV-associated cardiac lymphoma is generally poor because of widespread organ involvement, although some patients treated with combination chemotherapy have experienced clinical remission 50 .…”

Cardiac Tumor as an Initial Manifestation of Acquired Immunodeficiency Syndrome

“…AIDS-related non-Hodgkin's cardiac lymphoma as the first manifestation of cardiac involvement is rare [1][2][3][4] because the usual prognosis of AIDS with cardiac involvement is extremely poor, even with drastic multiagent chemotherapy. 1,5 In the present case, the tumor was associated with the concurrent HIV infection early after admission enabling prompt initiation of appropriate chemotherapy.…”

Manifestações cardiovasculares em pacientes com infecção pelo vírus da imunodeficiência humana

“…Fever, chest pain and coughing may be present. Pericardial involvement includes pericarditis, effusion with or without tamponade, constrictive pericarditis and neoplasic infiltration 13,18 . Most effusions are mild, without any hemodynamic change, with an annual incidence of 9% of tamponade.…”

“…Different rates of etiological identification are seen in the literature in accordance with the techniques used -direct analysis, cytology, immunofluorescence, immunoenzimatic tests, polymerase chain reaction, cultures or biopsies 13,15,18,20,21 . To this end, periocardiocentesis or pericardiostomy can be performed via biopsy.…”