title: Left ventricular thrombus in a patient with cutaneous T-cell lymphoma, hypereosinophilia and Mycoplasma pneumoniae infection - a challenging diagnosis: a case report.
abstract: Differential diagnoses of cardiac masses include primary benign and malignant neoplasms, secondary neoplasms, and non-neoplastic masses, such as thrombi. Owing to different therapeutic approaches and the way these affect the prognosis, the early and correct diagnostic determination of the etiology of a cardiac mass is of utmost importance and essential for the appropriate management of patients.We report a case of a 52-year-old woman with a left ventricular mass in the setting of a recent Mycoplasma pneumoniae infection and a medical history of cutaneous T-cell lymphoma and hypereosinophilia. Imaging findings were consistent with both an infiltrative process of the lymphoma and a cardiac thrombus. An estimated very high risk for embolization led to the indication for open-heart surgery for the removal of the cardiac mass. Histopathological examination confirmed the presence of a thrombus; there were no signs of malignancy. The patient was discharged 11 days after surgery in good general condition and is now in outpatient care for follow-up and further management.This case highlights possible challenges in the diagnostic assessment of cardiac masses and their management in a patient with several underlying diseases and a complex medical history.
authors.affiliation: Department of Surgery, Division of Cardiac Surgery, Vienna General Hospital, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria. claudia.oeser@meduniwien.ac.at.
authors.forename: Claudia
authors.initials: C
authors.lastname: Oeser
authors.affiliation: Department of Surgery, Division of Cardiac Surgery, Vienna General Hospital, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria. martin.andreas@meduniwien.ac.at.
authors.forename: Martin
authors.initials: M
authors.lastname: Andreas
authors.affiliation: Department of Surgery, Division of Cardiac Surgery, Vienna General Hospital, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria. claus.rath@meduniwien.ac.at.
authors.forename: Claus
authors.initials: C
authors.lastname: Rath
authors.affiliation: Department of Surgery, Division of Cardiac Surgery, Vienna General Hospital, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria. andreas.habertheuer@meduniwien.ac.at.
authors.forename: Andreas
authors.initials: A
authors.lastname: Habertheuer
authors.affiliation: Department of Surgery, Division of Cardiac Surgery, Vienna General Hospital, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria. alfred.kocher@meduniwien.ac.at.
authors.forename: Alfred
authors.initials: A
authors.lastname: Kocher
mesh_terms: D006348:Cardiac Surgical Procedures; D003937:Diagnosis, Differential; D005260:Female; D006331:Heart Diseases / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D017681:Hypereosinophilic Syndrome / Q000209:etiology; D016410:Lymphoma, T-Cell, Cutaneous / Q000150:complications*; D008875:Middle Aged; D011019:Pneumonia, Mycoplasma / Q000150:complications*; D012878:Skin Neoplasms / Q000150:complications*; D013927:Thrombosis / Q000175:diagnosis / Q000209:etiology*