Abstract
Cardiac involvement in non-Hodgkin’s lymphoma is a rare occurrence with a dismal prognosis, which may evolve with different clinical presentations, the most frequent being heart failure. Diagnosis of cardiac involvement is generally made by cardiac ultrasound. We report a case of lymphomatous pericarditis in the evolution of a non-Hodgkin’s lymphoma, diagnosed by PET-CT scan, and occurring concomitantly with complete isotopic remission of enlarged mediastinal lymph nodes following chemotherapy.
Highlights
Cardiac involvement in non-Hodgkin’s lymphoma is a rare occurrence with a dismal prognosis, which may evolve with different clinical presentations, the most frequent being heart failure
We report a case of lymphomatous pericarditis in the evolution of a non-Hodgkin’s lymphoma, diagnosed by PET-CT scan, and occurring concomitantly with complete isotopic remission of enlarged mediastinal lymph nodes following chemotherapy
We report on the case of a 51-year-old man diagnosed with a CD20-positive diffuse, large B-cell lymphoma (DLBCL), Ann Arbor stage IV, bulky, with an international prognostic index of
Summary
We report on the case of a 51-year-old man diagnosed with a CD20-positive diffuse, large B-cell lymphoma (DLBCL), Ann Arbor stage IV (bone marrow), bulky (largest retroperitoneal adenopathy of 18 cm), with an international prognostic index of. Rescue chemotherapy was initiated with two cycles of R-ESHAP (rituximab plus etoposide, cytarabine, methylprednisolone and cisplatin), with only minimal response Because of his young age and good performance index, continuation of the rescue treatment was decided, with two courses of IVA75 (ifosfamide, etoposide and doxorubicin), leading to partial remission. F-FDG PET scan evaluation showed complete remission of the enlarged mediastinal lymph nodes, and a large pericardial effusion (Fig. 1). The presence and development of lymphomatous pericardial effusion was discordant with complete remission of the mediastinal lymph nodes observed on the PET scan. A cycle of R-DA-EPOCH (dose-adjusted etoposide, doxorubicin, vincristine, cyclophosphamide and prednisone, plus rituximab) chemotherapy was administered This was followed by febrile neutropenia, and death due to septic shock 13 months after the initial diagnosis
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