Arrhythmias and Cardiogenic Shock: A Rare Disease Presentation of Diffuse Large B-Cell Lymphoma with Cardiac Involvement

Martina Bongiovanni,Sveva Pelliccia ,Simone Mariani ,Arianna Di Napoli,Monica Piedimonte,Agostino Tafuri,Maria Paola Bianchi ,Marco Testa

doi:10.3390/hemato2020021

Martina Bongiovanni, Sveva Pelliccia + Show 6 more

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https://doi.org/10.3390/hemato2020021

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Abstract

Extranodal involvement of non-Hodgkin lymphoma (NHL) has been reported in 20–40% of patients and has been typically observed in the skin, bones, gastrointestinal tract, liver and brain. Cardiac involvement has been reported in up to 20% of autopsy cases of patients with NHL and accounts for about 2% of all cardiac malignancies. Here, we report a peculiar case of a secondary cardiac diffuse large B-cell lymphoma (DLBCL), occurring with an abrupt hemodynamic instability, characterized by a sudden ventricular tachycardia and cardiogenic shock. The patient promptly started the first cycle of chemotherapy and was admitted to the cardiac intensive care unit (CICU) of our institution to prevent potential cardiovascular complications during treatment. We applied a fractionated treatment approach, progressively reaching standard doses, to decrease the risk of early death and ensure a successful management.

Highlights

Received: 10 May 2021Accepted: 31 May 2021Published: 1 June 2021Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations.diffuse large B-cell lymphoma (DLBCL) is the most frequent lymphoma associated with extranodal involvement with an incidence of 1.7 cases per 100,000 person-years [1]
According to the extensive cardiac involvement, careful management of the patient was ensured during all cycles of treatment by a fractionated chemotherapy approach
Secondary involvement by lymphoma is a condition described in 20% of cases lymphoma (PCL) is extremely rare, consisting in 1.3% of all primary cardiac n in studies post-mortem of patients with non-Hodgkin lymphoma but misdiagnosed at baseIn contrast, secondary involvement lymphoma is a condition described in 2 line

Summary

Introduction

Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. DLBCL is the most frequent lymphoma associated with extranodal involvement with an incidence of 1.7 cases per 100,000 person-years [1]. A reduced 5-year survival rate in patients with DLBCL and extranodal site involvement has been reported in comparison with those who do not present extranodal involvement, at 56 and 61%, respectively. Cardiac NHL involvement is often misdiagnosed, and, it is associated with a poor outcome because of delayed treatment. Reports on these patients are limited due to the lack of evidence-based data and controlled studies in which the diagnostic work-up and therapeutic management are well established. We report a case of secondary cardiac. DLBCL promptly diagnosed by multidisciplinary assessment, receiving a fractionated and tailored chemotherapy approach and achieving disease remission without complications

Case Report

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