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Case Reports
. 2025 Jan 4;20(1):17.
doi: 10.1186/s13019-024-03261-1.

Obstructive shock secondary to an unusual cause: primary cardiac lymphoma

Gregoire Ottavy  1 , Laurent Camous  2 , Claire Fieschi  3   4 , Lucas Della Torre  5 , Jean-David Pommier  1
Affiliations
Case Reports

Obstructive shock secondary to an unusual cause: primary cardiac lymphoma

Gregoire Ottavy et al. J Cardiothorac Surg. .

Abstract

Background: The medico-surgical management of cardiac tumors when there is a suspicion of malignancy is complex. Moreover, in a critically ill setting, the choice of diagnostic tools seems crucial.

Case presentation: We present the case of a sixty-four-year-old patient with no prior medical history who was admitted to the intensive care unit with obstructive shock secondary to a right heart mass and pulmonary embolism. Clinical and biological features revealed secondary hemophagocytic lympho-histiocytosis (HLH). The patient underwent a diagnostic procedure with dual thoracoscopic and mediastinoscopy with biopsies. Following the diagnosis of primary cardiac lymphoma, the patient received sequential chemotherapy without undergoing cardiac surgery leading to initial improvement, with reductions in intracardiac obstruction and in biomarkers associated with hemophagocytic lympho-histiocytosis.

Conclusion: When a cardiac mass is associated with extracardiac symptoms indicative of a hematological malignancy, the preferred treatment is chemotherapy, and cardiac surgery should be avoided.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: Informed consent for participation was obtained from the patient and the next of kin. Consent for publication: Consent was obtained from the patient for the publication of this report and any accompanying images. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
1/A et B Thoracic CT demonstarating a voluminous intra cardiac mass 1C/ Transthoracic echocardiography view depicting the intra right atrium tumour with tricuspid and septal involvement
Fig. 2
Fig. 2
Bone marrow aspirate stained with Wright-Giemsa of intracellular red blood cells macrophage (black arrow)
See this image and copyright information in PMC

References

    1. Tyebally S, Chen D, Bhattacharyya S, Mughrabi A, Hussain Z, Manisty C. Al Cardiac Tumors JACC CardioOncology June. 2020;2(2):293–311. - PMC - PubMed
    1. Li T, Zhang S, Liu C, Peng X, Gong S, Pan W. Long-term efficacy analysis of Surgical Resection of 70 primary right heart tumors. Cardiology. 2024;149(2):147–54. - PMC - PubMed
    1. Rendino E, Venuta F, De Giacomo T. and al. Comparative merits of thoracoscopy merits of thoracoscopy, mediastinoscopy and Mediastinoscopy for Mediastinal Biopsy Ann. Thora Surg. 1994:(57):992–5. - PubMed
    1. Yin K, Brydges H, Lawrence KW, Wei Y, Karlson KJ, McAneny DB. Primary cardiac lympho.ma. J Thorac Cardiovasc Surg August. 2022;164(2):573–e5801. - PubMed
    1. Petrich A, Cho SI, Billett H. Primary cardiac lymphoma: an analysis of presentation, treatment, and outcome patterns. Cancer Febr. 2011;117(3):581–9. - PubMed

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