[Cardiac extension of a non-Hodgkin lymphoma revealed by an atrial flutter].
Primary or secondary cardiac lymphomas are not frequent. Their clinical expression is unusual and the diagnosis is rarely made during the patient's life. Our case report, which is a slow atrial flutter with a pericardial effusion, is an uncommon discovery mode for a malignant lymphoma. Their diagnosis and the mechanism of the arythmia were allowed by non-invasive cardiac imagery (transesophageal echography and magnetic resonance imaging), which showed a tumour-like infiltration of the right atrium, of the right ventricle posterior wall, and of the atrioventricular junction. The diagnosis of a high grade B cell malignant non-hodgkin lymphoma, involving the bone marrow, the liver and the kidneys was made by biopsies of lymph nodes, histological analysis of the bone marrow, and a body CT scan. Throughout the first chemotherapy sequence, we observed a spontaneous return to a sinusal rhythm, and the cardiac MRI showed a regression of the myocardial infiltration and of the pericardial effusion; moreover, the patient's state improved and the peripheral lymph nodes shrank back to a normal size. However, the patient passed away, due to neurological complications 13 months after the diagnosis of lymphoma, without recurrence of cardiac involvement.
Mioulet
D
D
Service de cardiologie, hôpital d'instruction des armées-Laveran, 13, boulevard A.-Laveran, 13998 Marseille-Armées, France. dmioulet@yahoo.fr
Braem
L
L
Heno
P
P
Paule
P
P
Peloni
J-M
JM
Bonnet
D
D
Fourcade
L
L
D000328:Adult; D001282:Atrial Flutter / Q000209:etiology*; D006338:Heart Neoplasms / Q000150:complications*; D006801:Humans; D016393:Lymphoma, B-Cell / Q000150:complications*; D008297:Male