Journal of Chest Surgery

The Korean Society for Thoracic and Cardiovascular Surgery (대한심장혈관흉부외과학회)
권호 표지

Primary Malignant Cardiac Lymphoma in Right Atrium - A case report-

우심방에 발생한 원발성 악성 림프종의 수술적 치험 - 1예 보고 -

  • Choi, Won-Suk (Department of Thoracic and Cardiovascular Surgery, Pusan Paik Hospital, College of Medicine, Inje University) ;
  • Han, Il-Yong (Department of Thoracic and Cardiovascular Surgery, Pusan Paik Hospital, College of Medicine, Inje University) ;
  • Jun, Hee-Jae (Department of Thoracic and Cardiovascular Surgery, Pusan Paik Hospital, College of Medicine, Inje University) ;
  • Lee, Yang-Haeng (Department of Thoracic and Cardiovascular Surgery, Pusan Paik Hospital, College of Medicine, Inje University) ;
  • Hwang, Youn-Ho (Department of Thoracic and Cardiovascular Surgery, Pusan Paik Hospital, College of Medicine, Inje University) ;
  • Cho, Kwang-Hyun (Department of Thoracic and Cardiovascular Surgery, Pusan Paik Hospital, College of Medicine, Inje University)
  • 최원석 (인제대학교 의과대학 부산백병원 흉부외과학교실) ;
  • 한일용 (인제대학교 의과대학 부산백병원 흉부외과학교실) ;
  • 전희재 (인제대학교 의과대학 부산백병원 흉부외과학교실) ;
  • 이양행 (인제대학교 의과대학 부산백병원 흉부외과학교실) ;
  • 황윤호 (인제대학교 의과대학 부산백병원 흉부외과학교실) ;
  • 조광현 (인제대학교 의과대학 부산백병원 흉부외과학교실)
  • Published : 2008.06.05
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Abstract

A primary malignant lymphoma that originates in the heart is extremely rare. A 68-year-old male patient was admitted due to aggravated dyspnea. After echocardiography and chest computed tomography evaluation, a huge mass in the right atrium and the right ventricle was detected. We decided to perform emergency surgery due to a high risk of infarction and hemodynamic disturbance. After the near total removal of the huge mass in the right cardiac chamber, the interatrial septum and antero-lateral part of the right atrium were reconstructed by the use of a bovine pericardial patch. The final pathological diagnosis was a primary malignant lymphoma. The patient and his guardians refused chemotherapy (including radiotherapy), and the patient was discharged to his home, where the prognosis was hopeless.

심장에 발생하는 원발성 악성 림프종은 매우 드물다. 68세 남자 환자가 점점 심해지는 호흡곤란으로 본원 흉부외과에 입원하였다. 심장 초음파, 흉부컴퓨터단층촬영 후, 우심방과 우심실에 걸쳐 있는 거대 종양을 발견하였다. 뇌경색 등의 위험과 혈역학적 불안정으로 응급수술을 결정하였다. 우측 심장에 있는 거대 종양을 심방 중격의 일부와 전외측 우심방 벽을 함께 포함하여 제거하고, 우형 심내막 패치로 재건하였다. 최종 조직검사상 원발성 악성 림프종으로 진단되었으며, 환자와 보호자가 경제적 이유 등으로 항암치료를 거부하고 귀가 퇴원을 하였다.

Keywords

References

  1. Ceresoli GL, Ferreri AJM, Bucci E, Ripa C, Ponzoni M, Villa E. Primary cardiac lymphoma in immunocompetent patients. diagnostic and therapeutic management. Cancer 1997;80:1497- 506 https://doi.org/10.1002/(SICI)1097-0142(19971015)80:8<1497::AID-CNCR18>3.0.CO;2-0
  2. Yu SH, Lim SH, Hong YS, et al. Clinical experiences for primary cardiac tumors. Korean J Thorac Cardiovasc Surg 2005;38:301-7
  3. Won YS, Kim JH, Kweon JB, Park K, Kwack MS. A case of cardiac lymphoma developed in right atrium. Korean J Thorac Cardiovasc Surg 2000;33:971-3
  4. Park KS, Ahn WS, Lee S, Kwon OC, Ko MS, Jheon SH. Primary non-hodgkin's lymphoma in right ventricle with right atrial invasion: report of 1 case. Korean J Thorac Cardiovasc Surg 2004;37:376-81
  5. Fujisaki J, Tanaka T, Kato J, et al. Primary cardiac lymphoma presenting clinically as restrictive cardiomyopathy. Circ J 2005;69:249-52 https://doi.org/10.1253/circj.69.249
  6. Araoz PA, Eklund HE, Welch TJ, Breen JF. CT and MR imaging of primary cardiac malignancies. Radiographics 1999;19: 1421-34 https://doi.org/10.1148/radiographics.19.6.g99no031421
  7. Balasubramanyam A, Waxman M, Kazal HL, Lee MH. Malignant lymphoma of the heart in acquired immune deficiency syndrome. Chest 1986;90:243-6 https://doi.org/10.1378/chest.90.2.243
  8. Igawa T, Nagafuji K, Ejima J, et al. Surgical resection of malignant lymphoma the right atrium after systemic chemotherapy. Intern Med 2003;42:336-9 https://doi.org/10.2169/internalmedicine.42.336