[Successful Treatment of Malignant Lymphoma Arising from the Left Atrial Myxoma with Acute Myocardial Infarction;Report of a Case].
Primary cardiac malignant lymphoma within a cardiac myxoma is extremely rare. Here we report a case of a previously healthy 71-year-old woman who developed acute myocardial infarction. Transthoracic echocardiography showed a 69×45-mm solid tumor in the left atrium that was moving in a circular manner in the left atrial and ventricular cavities. Coronary angiography revealed an occlusion due to a coronary emboli in the distal part of the right coronary artery. Thrombectomy with an aspiration catheter was successfully performed to remove large red thrombi from the arterial lumen. Emergent surgical removal of the left atrial tumor along with tricuspid valve annuloplasty was performed under cardiopulmonary bypass. The postoperative course was uneventful. Histological examination demonstrated presence of malignant lymphoma within the myxoma. The patient was treated with rituximab, tetrahydropyranyl adriamycin, cyclophosphamide, vincristine, and predonisone (R-THP-COP) and is doing well without recurrence of lymphoma at 18-month follow-up. We emphasise that all surgical cardiac specimens should be sent for histological analysis aiming at the best treatment.
Department of Cardiovascular Surgery, Hachinohe City Hospital, Hachinohe, Japan.
Shinya
S
Masuda
Nobuhisa
N
Yajima
Shunichi
S
Kawarai
Tomoaki
T
Kagatani
Katsuo
K
Matsuki
D000368:Aged; D005260:Female; D006338:Heart Neoplasms / Q000473:pathology* / Q000628:therapy*; D006801:Humans; D008223:Lymphoma / Q000473:pathology* / Q000628:therapy*; D009203:Myocardial Infarction / Q000150:complications*; D009232:Myxoma / Q000473:pathology*; D009378:Neoplasms, Multiple Primary / Q000473:pathology*