Swinging heart caused by diffuse large B-cell lymphoma

Montañez-Valverde, Raúl A; Olarte, Neal; Zablah, Gerardo; Hurtado-de-Mendoza, David; Colombo, Rosario

doi:10.1093/omcr/omy075

Cited by 4 publications

(10 citation statements)

References 9 publications

(22 reference statements)

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Section: Discussionmentioning

confidence: 99%

“…3 Echocardiography is considered to be the primary imaging modality for pericardial effusion, and it is recommended to be done before, during, and after treatment to monitor the patient. 1,2 Lymphoma is a hematological malignancy that emerges from the clonal proliferation of lymphocytes at different maturation stages. It presents with fatigue, night sweats, enlarged painless lymph nodes, and weight loss.…”

Section: Discussionmentioning

confidence: 99%

“…One of the important causes of pericardial effusion are solid tumors. 1 Pericardial involvement from non‐Hodgkin lymphoma is uncommon and malignant pericardial effusion is even more scarce. 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.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

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

Alizadeh

Shaye

Badiea

et al. 2021

Clinical Case Reports

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

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

Alizadeh

Shaye

Badiea

et al. 2021

Clinical Case Reports

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“…Diagnostic suspicion is based on an enlarged cardiac silhouette on the chest X-ray. The characteristic "swinging heart" was reported in massive pericardial effusions with the particular pattern of electrical alternans [24].…”

Section: Discussionmentioning

confidence: 99%

Primary Idiopathic Chylopericardium as Unusual Cause of Cardiac Tamponade

Aranalde¹,

Lorenzin²,

Cánaves³

et al. 2019

AJIM

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The chylopericardium is defined as the accumulation of chylous fluid containing high concentrations of triglycerides in the pericardial space. It is quite an uncommon condition first described in 1888 by Hasebroek. The absence of an underlying etiology defines it as primary idiopathic chylopericardium, term initially used in a study by Groves and Effler in 1954. Even when most patients are asymptomatic, constrictive pericarditis or cardiac tamponade may be referred. Cardiac tamponade, the most serious complication, represents an entity characterized by fluid accumulation in the pericardial cavity. Claudius Galen from Pergamum (131-201 D. C.) described pericardial effusions in gladiators with stab injuries of the chest and Richard Lowe (1669) described its physiology. It took two hundred years for the term "cardiac tamponade" was coined by german surgeon Edmund Rose. Cardiac tamponade can be presented from asymptomatic setting to life-threatening conditions. By the former reason, the early recognition of this entity has crucial importance. Idiopathic chylopericardium occurs in all age groups and affects both sexes equally. Although several mechanisms have been proposed in order to explain the development of chylopericardium, the underlying pathophysiology remains unclear. Damaged lymphatic vessels with abnormal communication of the thoracic duct to the pericardial lymphatics and elevated pressure in the thoracic duct can justify the presence of chyle into the pericardial sac. Diagnosis is confirmed by pericardiocentesis which must reveal at least two of the classical five criteria. Chylopericardium may be managed through conservative or surgical treatment. The conservative treatment consist a medium chain triglyceride diet or total parenteral nutrition but has a high degree of recurrence, for which reason the safest option is thoracic duct ligation with a pericardial window. The present study reports a case of chylopericardium wherein the leak was diagnosed by lymphoscintigraphy that was successfully treated by a low-fat diet, rich in medium-chain triglycerides and octreotide infusion.

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“…This is an uncommon case where not only were two primary tumors detected simultaneously, but also the patient deteriorated clinically and was noted to have concurrent SVC syndrome and cardiac tamponade. While SVC syndrome is commonly seen with tumors presenting with mediastinal masses, literature search shows only one prior case of cardiac tamponade resulting from DLBCL [4].…”

Section: Introductionmentioning

confidence: 99%

Concurrent Cardiac Tamponade and Superior Vena Cava Syndrome: A Concerning Situation

Asif

Mahmood

Pauly

2019

Cureus

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Diffuse large B-cell lymphoma (DLBCL) is the most commonly diagnosed lymphoma; as per the Surveillance, Epidemiology, and End Results (SEER) database 2006-2015, incidence of DLBCL is 7.0/100,000 per year. Superior vena cava (SVC) syndrome and cardiac tamponade are life-threatening oncological emergencies with an overlap in clinical manifestations. While SVC syndrome may commonly be seen with mediastinal masses, literature search shows only one prior case of cardiac tamponade resulting from DLBCL. Here, we present a case of a patient with a concurrent diagnosis of DLBCL and non-small cell carcinoma of the lung (NSCLC), presenting with respiratory symptoms initially but subsequently worsening with hemodynamic compromise. He was found to have cardiac tamponade secondary to DLBCL and was treated appropriately for it but failed to improve clinically due to co-existing SVC syndrome that was not treated. The patient expired in the intensive care unit (ICU) within 24 hours of acute clinical deterioration. This case highlights that in absence of a clinical suspicion for both conditions, identification of one can lead to an overlooked diagnosis of the other. When associated with hemodynamic instability, urgent intervention is mandatory and failure to recognize and treat either of the two may result in grave outcome. This case attempts to alert medical personnel regarding two major oncological emergencies where an accurate diagnosis and urgent intervention can prevent mortality and morbidity.

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Swinging heart caused by diffuse large B-cell lymphoma

Cited by 4 publications

References 9 publications

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

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

Primary Idiopathic Chylopericardium as Unusual Cause of Cardiac Tamponade

Concurrent Cardiac Tamponade and Superior Vena Cava Syndrome: A Concerning Situation

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