Ischemic heart disease due to compression of the coronary arteries by malignant lymphoma.
A 76-year-old man presented with a two-month history of angina pectoris. Computed tomography (CT) revealed a serial enlargement of the supraclavicular and mediastinal lymph nodes compressing the heart, pulmonary artery and aorta. CT angiography (CTA) showed stenosis of the coronary arteries as a result of compression by the enlarged lymph nodes. First-pass contrast-enhanced cardiac magnetic resonance imaging (MRI) at rest revealed a perfusion defect, thus indicating myocardial ischemia. Diffuse large B-cell lymphoma was diagnosed and multidrug combination chemotherapy led to prompt improvement of the symptoms. Relief of the stenosis in the coronary arteries and improvements in myocardial perfusion were noted on follow-up CTA and MRI.
Division of Hematology, St. Luke's International Hospital, Japan.
Yuki
Y
Nagasako
Shun
S
Akaeda
Fumitaka
F
Yanase
Ryosuke
R
Koyamada
Atsushi
A
Mizuno
Takakazu
T
Higuchi
Sadamu
S
Okada
D000368:Aged; D003331:Coronary Vessels / Q000473:pathology*; D006801:Humans; D008223:Lymphoma / Q000150:complications / Q000175:diagnosis; D016393:Lymphoma, B-Cell / Q000150:complications* / Q000175:diagnosis*; D008297:Male; D017202:Myocardial Ischemia / Q000175:diagnosis* / Q000209:etiology*