title: Case report of precursor B-cell lymphoblastic lymphoma presenting as syncope and cardiac mass in a nonimmunocompromised child.
abstract: We report the case of a previously healthy, 10-year-old boy who presented to the emergency department with a syncopal episode. In the emergency department, the patient was diagnosed with a right atrial mass, later identified as a precursor B-cell lymphoblastic lymphoma (LL). Most causes of syncope in children are not life threatening. In most cases, it indicates a predisposition to vasovagal episodes. Lymphomas account for approximately 7% of malignancies among children younger than 20 years, are more common in white males and immunocompromised patients, and are predominantly tumors of T-cell origin. Children with non-Hodgkin lymphoma usually present with extranodal disease, most frequently involving the abdomen (31%), mediastinum (26%), or head and neck (29%). Our patient was unique in that he was a nonimmunocompromised, black boy, presenting with syncope in the setting of a large atrial mass identified as a precursor B-cell LL. To our knowledge, there are no reported cases of precursor B-cell LL presenting as syncope and a cardiac mass.
authors.affiliation: Department of Emergency Medicine, Staten Island University Hospital, Staten Island, New York, NY 10305, USA. Barry_Hahn@yahoo.com
authors.forename: Barry
authors.initials: B
authors.lastname: Hahn
authors.forename: Sudha
authors.initials: S
authors.lastname: Rao
authors.forename: Binita
authors.initials: B
authors.lastname: Shah
mesh_terms: D000972:Antineoplastic Agents, Phytogenic / Q000627:therapeutic use; D002648:Child; D006325:Heart Atria / Q000473:pathology / Q000601:surgery; D006338:Heart Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000601:surgery; D006801:Humans; D016393:Lymphoma, B-Cell / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000601:surgery; D008297:Male; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000601:surgery; D013575:Syncope / Q000209:etiology*; D016896:Treatment Outcome; D014750:Vincristine / Q000627:therapeutic use
chemical_list: D000972:Antineoplastic Agents, Phytogenic; D014750:Vincristine