内容紹介
Cardiac Diffuse Large B-Cell Lymphoma Presenting with Acute Heart Failure Due to Cardiac Tamponade
Summary
A 75-year-old man was admitted to our hospital in May 2016 with progressive shortness of breath. We considered him to be experiencing acute heart failure caused by atrial fibrillation. Contrast-enhanced computed tomography showed a hypo-dense mass involving the right atrium and left ventricle, pericardial effusion, and lymphadenopathy of the groin. Histological finding from the groin and pericardial effusion analysis showed diffuse large B-cell lymphoma(DLBCL). We thus diagnosed this patient with cardiac tamponade owing to the involvement of the heart by DLBCL. Treatment was initiated with tetrahydropyranyldoxorubicin/cyclophosphamide/vincristine/prednisolone(THP-COP)therapy(50% dose)and continuous pericardial drainage. We carefully added rituximab 4 days after monitoring his symptoms and vital signs. There were a few adverse effects, and after treatment, the mass and pericardial effusion disappeared. Subsequently, 8 courses of THP-COP therapy accompanied by rituximab(R-THP-COP)(full dose)were administered, resulting in a complete response.
要旨
症例は75歳,男性。2016年5月に息切れのため受診した。心房細動と心不全のため入院となり,造影CT検査で左室・右房腫瘤と心囊液貯留および右鼠径リンパ節腫脹を認めた。鼠径リンパ節生検にて,びまん性大細胞型B細胞リンパ腫(diffuse large B-cell lymphoma: DLBCL)と診断した。心囊液からDLBCLの細胞を認め,DLBCLの心臓浸潤による心タンポナーデと診断し,持続心囊ドレナージを行った。心不全を伴うことから減量tetrahydropyranyldoxorubicin/cyclophosphamide/vincristine/prednisolone(THP-COP)療法(50% dose)を行い,その5日後にrituximabを追加した。その後,心筋内のリンパ腫は著明に縮小し,心囊液は消失した。以降は標準投与量でrituximab併用THP-COP(R-THP-COP)療法を8コース行い,完全寛解が得られた。
目次
Summary
A 75-year-old man was admitted to our hospital in May 2016 with progressive shortness of breath. We considered him to be experiencing acute heart failure caused by atrial fibrillation. Contrast-enhanced computed tomography showed a hypo-dense mass involving the right atrium and left ventricle, pericardial effusion, and lymphadenopathy of the groin. Histological finding from the groin and pericardial effusion analysis showed diffuse large B-cell lymphoma(DLBCL). We thus diagnosed this patient with cardiac tamponade owing to the involvement of the heart by DLBCL. Treatment was initiated with tetrahydropyranyldoxorubicin/cyclophosphamide/vincristine/prednisolone(THP-COP)therapy(50% dose)and continuous pericardial drainage. We carefully added rituximab 4 days after monitoring his symptoms and vital signs. There were a few adverse effects, and after treatment, the mass and pericardial effusion disappeared. Subsequently, 8 courses of THP-COP therapy accompanied by rituximab(R-THP-COP)(full dose)were administered, resulting in a complete response.
要旨
症例は75歳,男性。2016年5月に息切れのため受診した。心房細動と心不全のため入院となり,造影CT検査で左室・右房腫瘤と心囊液貯留および右鼠径リンパ節腫脹を認めた。鼠径リンパ節生検にて,びまん性大細胞型B細胞リンパ腫(diffuse large B-cell lymphoma: DLBCL)と診断した。心囊液からDLBCLの細胞を認め,DLBCLの心臓浸潤による心タンポナーデと診断し,持続心囊ドレナージを行った。心不全を伴うことから減量tetrahydropyranyldoxorubicin/cyclophosphamide/vincristine/prednisolone(THP-COP)療法(50% dose)を行い,その5日後にrituximabを追加した。その後,心筋内のリンパ腫は著明に縮小し,心囊液は消失した。以降は標準投与量でrituximab併用THP-COP(R-THP-COP)療法を8コース行い,完全寛解が得られた。