title: Complete heart block as a complicating feature of a mediastinal lymphoma.
abstract: Malignant lymphomas represent about 9% of cardiac neoplasms. Despite its life-threatening nature, the cardiac manifestations are often subclinical. In about 20% of deaths from lymphoma, cardiac involvement is found only in autopsy. The authors present the case of a 77-year-old female admitted due to intense back pain, vomiting, generalised pruritus, fatigue and weight loss. She had a personal history of hypertension and breast cancer was noted 10 years before admission. The thoracoabdominopelvic CT showed a mass in the left atrium with extension to the right atrium and inferior vena cava, and a paravertebral mass at D10-D11 with invasion of the spinal canal and hepatic hilum. The transthoracic paravertebral mass biopsy was compatible with a diffuse large B cell lymphoma. The patient developed a complete atrioventricular block, with haemodynamic instability, requiring urgent chemoreduction of the paracardiac mass and implantation of an epicardial pacemaker.
authors.affiliation: Department 2, Curry Cabral's Hospital, Lisbon, Portugal. vandacristinajorge@gmail.com
authors.forename: Vanda Cristina
authors.initials: VC
authors.lastname: Jorge
authors.forename: Vera
authors.initials: V
authors.lastname: Bernardino
authors.forename: Ana Carolina
authors.initials: AC
authors.lastname: Araújo
authors.forename: Sara
authors.initials: S
authors.lastname: Gomes
authors.forename: Carla
authors.initials: C
authors.lastname: Noronha
authors.forename: Nuno
authors.initials: N
authors.lastname: Riso
authors.forename: Manuel
authors.initials: M
authors.lastname: Vaz Riscado
mesh_terms: D000368:Aged; D001706:Biopsy; D003937:Diagnosis, Differential; D005260:Female; D006327:Heart Block / Q000175:diagnosis* / Q000209:etiology* / Q000628:therapy; D006801:Humans; D016403:Lymphoma, Large B-Cell, Diffuse / Q000150:complications* / Q000175:diagnosis*; D008479:Mediastinal Neoplasms / Q000150:complications* / Q000175:diagnosis*; D010138:Pacemaker, Artificial; D014057:Tomography, X-Ray Computed