Cardiac tamponade as primary manifestation of angioimmunoblastic T-cell lymphoma (AILT). Coexistence with malignant mesothelioma.
BACKGROUND
Cardiac tamponade (CT) as the primary clinical manifestation of lymphomas is extremely rare. Angioimmunoblastic T-cell lymphoma (AILT) is characterised by systemic disease usually presenting with generalised peripheral lymphadenopathy, hepatosplenomegaly, and bone marrow infiltration.


METHODS
We report on a 59-year-old male patient with CT as initial clinical manifestation of AILT. Coexistence with malignant pleural mesothelioma was additionally revealed. Cytologic examination of pericardial fluid presented diffuse lymphoid cells and sporadic malignant mesothelial cells. AILT diagnosis was confirmed by thoracoscopic mediastinal lymph node and bone marrow biopsy. Despite the presence of pleural effusion, the diagnosis of mesothelioma was initially established by cytologic ex-amination of pericardial fluid, due to the patient's critical cardiac condition requiring prompt subxiphoid pericardiocentesis.


CONCLUSIONS
CT as primary clinical manifestation of AILT is very rare. This case reflects the differences in the underlying biology of AILT and consequently the vast spectrum of its clinical presentations. Coexistence of AILT with malignant pleural mesothelioma is also extremely rare.
Department of Cardiology, Theagenion Cancer Hospital, Thessaloniki, Greece. iatros@the.forthnet.gr
Christos
C
Lafaras
Eudokia
E
Mandala
Ioannis
I
Venizelos
Rosalia
R
Valeri
Nikos
N
Barbetakis
Theodoros
T
Bischiniotis
D002305:Cardiac Tamponade / Q000175:diagnosis* / Q000209:etiology*; D006801:Humans; D007119:Immunoblastic Lymphadenopathy / Q000150:complications* / Q000175:diagnosis*; D008223:Lymphoma / Q000150:complications* / Q000175:diagnosis*; D008297:Male; D008654:Mesothelioma / Q000150:complications* / Q000175:diagnosis*; D008875:Middle Aged