title: Malignant lymphoma with cardiac involvement.
abstract: Malignant lymphoma with cardiac involvement is difficult to diagnose and treatment selection decisions can be challenging, because patients usually present with atypical disease involvement and the incidence is low. Herein, we describe the clinical characteristics and courses of three non-Hodgkin lymphoma patients showing cardiac involvement. All three patients were male, ages 32, 74 and 64 years. All three patients had presented with cardiac involvement mainly in the right heart system. We promptly performed needle biopsies for patients 1 and 3, and open-heart biopsy for patient 2, which showed PMBL for patient 1, DLBCL for patients 2 and 3. Since we were concerned regarding possible transient exacerbation of heart failure or the occurrence of fatal arrhythmia, we chose to start with relatively low dose chemotherapeutic interventions or pre-phase steroid therapy. After one course of chemotherapy or pre-phase steroid therapy, symptoms associated with heart failure almost completely subsided, and we further administered full-dose chemotherapy thereafter, resulting in complete responses in 2 cases. This case series demonstrates that malignant lymphoma with cardiac involvement is a treatable disease, despite widespread involvement. Furthermore, rapid and appropriate diagnostic imaging and biopsy are important when this disease is suspected.
authors.affiliation: Department of Hematology, Nagoya University Hospital.
authors.forename: Seitaro
authors.initials: S
authors.lastname: Terakura
authors.forename: Masaaki
authors.initials: M
authors.lastname: Onji
authors.forename: Chisako
authors.initials: C
authors.lastname: Iriyama
authors.forename: Tatsunori
authors.initials: T
authors.lastname: Goto
authors.forename: Yoko
authors.initials: Y
authors.lastname: Ushijima
authors.forename: Kazuyuki
authors.initials: K
authors.lastname: Shimada
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Ishikawa
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Nishida
authors.forename: Fumihiko
authors.initials: F
authors.lastname: Hayakawa
authors.forename: Makoto
authors.initials: M
authors.lastname: Murata
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Kiyoi
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D006338:Heart Neoplasms / Q000175:diagnosis / Q000188:drug therapy*; D006801:Humans; D008223:Lymphoma / Q000175:diagnosis / Q000188:drug therapy*; D016403:Lymphoma, Large B-Cell, Diffuse / Q000175:diagnosis / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents