Severe right ventricular outflow tract obstruction caused by non-hodgkin lymphoma: complete regression after one course of bendamustine/rituximab therapy.
We present the case of a 67-year-old woman presenting with symptoms of predominantly right heart failure caused by cardiac tumor infiltration. Echocardiography showed almost complete obstruction, particularly of the right ventricular outflow tract. After complete diagnostic workup, treatment with only one course of bendamustine and rituximab resulted in complete resolution of the obstruction. Right ventricular outflow tract restriction due to infiltrative large B-cell lymphoma is a rare finding. Compression of the heart and great vessels, such as by mediastinal tumors, is not as rare. Prompt and accurate diagnosis by echocardiography and immediate initiation of treatment can be lifesaving.
Department of Cardiology, Angiology and Pneumology, University of Heidelberg, Im Neuenheimer Feld 410, Heidelberg, Germany. mathias.konstandin@med.uni-heidelberg.de
Mathias H
MH
Konstandin
Grigorios
G
Korosoglou
Waldemar
W
Hosch
Stefan E
SE
Hardt
Hugo A
HA
Katus
Derliz
D
Mereles
D000368:Aged; D058846:Antibodies, Monoclonal, Murine-Derived / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D000069461:Bendamustine Hydrochloride; D003937:Diagnosis, Differential; D004359:Drug Therapy, Combination; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016393:Lymphoma, B-Cell / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D009588:Nitrogen Mustard Compounds / Q000627:therapeutic use*; D020127:Recovery of Function / Q000502:physiology*; D000069283:Rituximab; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed; D016278:Ventricular Function, Right / Q000502:physiology*; D014694:Ventricular Outflow Obstruction / Q000000981:diagnostic imaging / Q000209:etiology*
D058846:Antibodies, Monoclonal, Murine-Derived; D000970:Antineoplastic Agents; D009588:Nitrogen Mustard Compounds; D000069283:Rituximab; D000069461:Bendamustine Hydrochloride