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Non Hodgkin’s Lymphoma with Right Atrial Intra Cardiac Metastases

World Journal of Cardiovascular Surgery 2023年第7期13卷 120-127页

作者： Gaind Saurabh Nitin Kumar Kashyap Mehsare Pranay Suresh Niraghatam Harshavardhan Nirupam Sekhar Chakraborty rahul satarkar Mudalsha Ravina Shiva Thakur Department of Cardio Thoracic and Vascular Surgery All India Institute of Medical Sciences Raipur India Department of Cardio Thoracic and Vascular Surgery Apollo Hospitals Kakinada India Department of Pathology All India Institute of Medical Sciences Raipur India Department of Nuclear Medicine All India Institute of Medical Sciences Raipur India

Background: Diffuse Large B-Cell Lymphoma (DLBCL) is the most variant of Non-Hodgkin’s Lymphoma (NHL) and also the most common variant with secondary intracardiac masses. Case summary: 7 years old child presented to emergency with acute decompensated cardiac failure, ascites and tender hepatomegaly. 2D echo evaluation was suggestive of large intracardiac mass in the right atrium almost completely obstructing Tricuspid valve orifice, gross pericardial effusion and dilated Inferior Vena Cava (IVC). Emergency tumor excision surgery was performed which revealed 4 × 4 cm pinkish firm mass arising from anterior Tricuspid annulus which was completely excised. Child was extubated on postoperative day (POD) 0 and was on minimal inotropic support. Ascites reduced significantly on POD1 allowing abdominal palpation which revealed a mass in the epigastric region. This prompted evaluation by pediatrician and oncology workup suggestive of increased 18-Flouro Deoxy Glucose (18-FDG) uptake in the mediastinum, abdomen, bilateral proximal thighs, all mediastinal lymph nodal stations, bilateral lung hilar stations 10R, 10L involving all encasing the heart and great vessels with pleural deposits, Celiac trunk, superior Mesenteric Artery (SMA), Portal vein, IVC and abdominal aorta. Histo pathology Examination (HPE) and Immuno Histo Chemistry (IHC) of intracardiac mass revealed DLBCL which is metastatic in nature. Chemotherapy was started as per (French American British Lymphomes Malins B) FAB LMB-96 protocol with the child currently in the Induction phase having poor prognosis and less survival interval. Conclusion: Surgery can be considered a treatment option for metastatic intracardiac masses during emergency scenarios like cardiogenic shock to relieve obstruction along the pathway of blood flow in the heart even though we may not be able to completely excise the tumor surgically.

关键词： Diffuse Large B-Cell Lymphoma (DLBCL) Non-Hodgkin’s Lymphoma (NHL) Secondary Intracardiac Metastasis Cardiogenic Shock Immuno Histo Chemistry (IHC)

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Non Hodgkin’s Lymphoma with Right Atrial Intra Cardiac Metastases

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World Journal of Cardiovascular Surgery（心血管外科国际期刊） 2023年第7期

作者： Gaind Saurabh Nitin Kumar Kashyap Mehsare Pranay Suresh Niraghatam Harshavardhan Nirupam Sekhar Chakraborty rahul satarkar Mudalsha Ravina Shiva Thakur

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