Obstructive Primary Cardiac T-Cell Lymphoma: A Case Report from Senegal.
BACKGROUND Cardiac lymphoma is a rare entity, defined by the non-extra cardiac location at diagnosis. CASE REPORT Our patient was a 32-year-old female with no particular medical history, who presented with right heart failure with recurrent ascites and pleural effusion. There was a progressive worsening exertional dyspnea. On admission, examination revealed an irregular tachycardia at 170 beats per minute (bpm) and congestive heart failure. The electrocardiogram scored full tachyarrhythmia by atrial fibrillation with an average ventricular rate of 179 cycles per minute. Doppler echocardiography showed dilatation and systolic dysfunction of the left ventricle. There were dilated atria. We noted a large mass in the right atrium, which was less mobile, heterogeneous, integral with the wall, and filling three quarters of the cavity. It clogged the tricuspid valve in diastole. CT scan showed a tissue process enhanced after contrast injection, occupying the predominant cavities in the right atrium and filling it. Its borders were irregular. The lesion was extended to the posterior mediastinum, in front of the vertebral axis. In addition, there was a thrombosis of the jugular vein and the inferior vena cava. There was no other tumor site noted. The patient died after presenting with cardiovascular shock associated with refractory right heart failure. Pathology examination confirmed T-cell lymphoma. CONCLUSIONS The primitive cardiac lymphoma is an entity of intra-cardiac masses. It is therefore to be considered even if the diagnosis is challenging.
Department of Cardiology, Teaching Hospital Aristide Le Dantec, Dakar, Senegal.
Simon Antoine
SA
Sarr
Department of Anatomopathology, Teaching Hospital Aristide Le Dantec, Dakar, Senegal.
Abdou Majib
AM
Gaye
Department of Cardiology, Teaching Hospital Aristide Le Dantec, Dakar, Senegal.
Fatou
F
Aw
Department of Cardiology, Teaching Hospital Aristide Le Dantec, Dakar, Senegal.
Jean
J
de Dieu Nzambaza
Department of Cardiology, Teaching Hospital Aristide Le Dantec, Dakar, Senegal.
Malick
M
Bodian
Department of Cardiology, Teaching Hospital Aristide Le Dantec, Dakar, Senegal.
Kana
K
Babaka
Department of Cardiology, Teaching Hospital Aristide Le Dantec, Dakar, Senegal.
Mouhamadou Bamba
MB
Ndiaye
Department of Cardiology, Teaching Hospital Aristide Le Dantec, Dakar, Senegal.
Adama
A
Kane
Department of Cardiology, Teaching Hospital Aristide Le Dantec, Dakar, Senegal.
Maboury
M
Diao
Department of Cardiology, Teaching Hospital Aristide Le Dantec, Dakar, Senegal.
Serigne Abdou
SA
Ba
D000328:Adult; D017809:Fatal Outcome; D005260:Female; D006325:Heart Atria / Q000473:pathology*; D006333:Heart Failure / Q000209:etiology*; D006338:Heart Neoplasms / Q000150:complications* / Q000473:pathology; D006801:Humans; D016399:Lymphoma, T-Cell / Q000150:complications* / Q000473:pathology; D017202:Myocardial Ischemia / Q000209:etiology; D012770:Shock, Cardiogenic / Q000209:etiology