Late cardiac effect of radiation therapy on a young woman with mediastinal Hodgkin's lymphoma.
We experienced an excision of the mediastinal tumor located in left anterior mediastinum found in a 21-year-old woman. The histologic diagnosis of Hodgkin's lymphoma was obtained. After operation, she was treated with mantle field radiotherapy (total 42 Gy) followed by chemotherapy. At 43-year old, she developed constrictive pericarditis and heart failure resulted in the late cardiac effects of mediastinal irradiation. Despite pericardiectomy followed by medical treatment, her cardiac symptoms gradually worsened and she died at 51-year old. At autopsy, her heart was smaller than normal person. The residual pericardium and the surface of the myocardium had fibrous degeneration with tight adhesion and thickness that were dominant at the right atrium and ventricle. Likewise, we demonstrated that pericardiectomy scarcely led to a favorable outcome in this patient. These facts might be based on the radiation-associated cardiac effects involving any components of the cardiac structure.
Department of Thoracic Surgery, Yao Municipal Hospital, 1-3-1 Ryuge-cho, Yao, Osaka, 581-0069, Japan. cfaem800@jtw.zaq.ne.jp.
Ken
K
Kodama
Department of Cardiology, Kinki Central Hospital, Itami, Hyogo, Japan.
Hiroshi
H
Takami
Department of Cardiology, Kinki Central Hospital, Itami, Hyogo, Japan.
Masahiro
M
Izumi
Department of Cardiology, Kinki Central Hospital, Itami, Hyogo, Japan.
Yoshimune
Y
Hiramoto
Department of Pathology, Kinki Central Hospital, Itami, Hyogo, Japan.
Kyotaro
K
Yoshida
Department of Surgery, Kinki Central Hospital, Itami, Hyogo, Japan.
Kiyonori
K
Nishioka
Department of Thoracic Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan.
Masahiko
M
Higashiyama
D017809:Fatal Outcome; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000209:etiology*; D006689:Hodgkin Disease / Q000532:radiotherapy*; D006801:Humans; D008479:Mediastinal Neoplasms / Q000532:radiotherapy*; D010492:Pericardiectomy; D010494:Pericarditis, Constrictive / Q000209:etiology*; D011832:Radiation Injuries / Q000209:etiology*; D018714:Radiotherapy, Adjuvant / Q000009:adverse effects; D055815:Young Adult
Constrictive pericarditis; Hodgkin’s lymphoma; Mediastinal irradiation