[Sick sinus syndrome after chemotherapy for malignant lymphoma with right atrial tumor at initial presentation].
A 56-year-old man was admitted complaining of throat discomfort and dyspnea. He was given a diagnosis of diffuse large B-cell lymphoma on the basis of findings from tumor biopsy specimens of his left pharynx. MRI tomograms and ultrasonic cardiograms revealed a right atrial tumor causing tricuspid stenosis. Although chemotherapy rendered the cardiac tumor indistinct on MRI and UCG images, gallium-67 scintigraphy still demonstrated abnormal cardiac uptake. After 6 courses of CHOP therapy, sick sinus syndrome with syncope suddenly developed in the patient. A cardiac pacemaker was immediately implanted, and radiotherapy was started. The patient's sinus rhythm returned to normal shortly afterward, and the gallium-67 uptake eventually disappeared. In this case gallium-67 scintigraphy was the only diagnostic procedure capable of detecting evidence of residual disease.
Department of Internal Medicine, Chugoku Central Hospital of the Mutual Aid Association of Public School Teachers.
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Miyata
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Fujiwara
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S
Fujii
T
T
Kikuchi
T
T
Osada
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D003520:Cyclophosphamide / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D005710:Gallium Radioisotopes; D006325:Heart Atria; D006338:Heart Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging*; D006801:Humans; D016403:Lymphoma, Large B-Cell, Diffuse / Q000188:drug therapy*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011241:Prednisone / Q000008:administration & dosage; D011877:Radionuclide Imaging; D012804:Sick Sinus Syndrome / Q000209:etiology*; D014264:Tricuspid Valve Stenosis / Q000209:etiology; D014750:Vincristine / Q000008:administration & dosage
D005710:Gallium Radioisotopes; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone