Author:
Wang Hua,Yan Wei-hong,Sun Jun-jie,Dong Mei,Zhang Nan,Liu Tong,Song Nian-peng,Zhong Lin
Abstract
Abstract
Background
Richter’s syndrome (RS) defines the transformation of chronic lymphocytic leukemia into high-grade lymphoma, which usually involves lymph nodes and bone marrow. Extranodal involvement of the heart is an extremely rare condition. Patients with heart involvement tended to have a low response to chemotherapy and relative poor prognosis. The transformation process of RS is often insidious and nonspecific making it challenging to diagnose.
Case presentation
A 64-year-old woman wih a history of chronic lymphocytic leukemia (CLL) presented with intermittent chest pain and was diagnosed with non-ST-elevation myocardial infarction (NSTEMI). However, the contrast enhanced echocardiography revealed a large irregular mass, measuring about 75.4 mm × 37.5 mm, located on the lateral and posterior wall of the right ventricle. Biopsy of the cardiac mass and the results revealed diffuse large B-cell lymphoma.
Conclusions
We present a case of a 64-year-old woman with aggressive diffuse large B-cell lymphoma involving the heart. This case could provide some insights in the diagnosis of cardiac lymphoma.
Funder
the National Natural Science Foundation of China
the Science and Technology planning project of Yantai City
the Shandong Provincial Medical and Health Plan
Publisher
Springer Science and Business Media LLC
Subject
Cardiology and Cardiovascular Medicine
Reference8 articles.
1. Lortholary P, Boiron M, Ripault P, Levy JP, Manus A, Bernard J. Chronic lymphoid leukemia secondarily associated with a malignant reticulopathy: Richter’s syndrome. Nouv Rev Fr Hematol. 1964;4:621–4.
2. Richter MN. Generalized reticular cell sarcoma of lymph nodes associated with lymphatic leukemia. Am J Pathol. 1928;4:285-92.7.
3. Molica S. A systematic review on Richter syndrome: what is the published evidence? Leuk Lymphoma. 2010;51:415–21.
4. Allan JN, Furman RR. Current trends in the management of Richter’s syndrome. Int J Hematol Oncol. 2019;7(4):IJH09.
5. Takeuchi M, Ogunyankin K, Pandian NG, McCreery TP, Sweitzer RH, Caldwell VE, et al. Enhanced visualization of intravascular and left atrial appendage thrombus with the use of a thrombus-targeting ultrasonographic contrast agent (MRX-408A I): In vivo experimental echocardiographicstudies. J Am Soc Echocardiogr. 1999;12:1015–102.