Article Sidebar
Main Article Content
Abstract
Highlight:
- A 32-year-old male patient suffered mediastinal non-hodgkin's lymphoma metastatic to the right atrium which mimicked right atrial myxoma.
- The patient died of suspected mediastinal NHL thromboembolism that spread in the right atrium.
Abstract:
In this case report, the anatomical pathology results in the form of B cell type LNH, but at the age of 32 years and the risk factor in this patient was a former active smoker. In the anatomical pathology results, the results of the B-High Grade Cell Type LNH were also obtained. B-cell type non-hodgkin's lymphoma can be mutated in the MYC gene (v-myc avian myceloctomatosis viral oncogene homolog) and the BCL-2 and BCL-6 (B-cell lymphoma) genes. If this morphology is found, then the patient's prognosis is poor. Most of these patients were males and the incidence was in the mediastinal area. Mediastinal NHL could develop and enlarge to involve the heart and pericardium. The spread could occur directly and lymphogens. These metastatic tumors were often misdiagnosed with atrial myxoma. In this case report, exploration of the right atrium and open mediastinal biopsy was performed. An open biopsy of the mediastinum revealed a mediastinal mass that enlarged to enter the right atrium. Atrial myxoma was not found. Primary lymphoma growth could also occur in the heart. This condition was called primary cardiac lymphoid (PCL). This case was very rare and was often considered an atrial myxoma. The patient died 10 days after discharge from the hospital. While the patient was eating, the patient had a seizure and the patient was immediately taken to the emergency department of Dr. Soetomo General Academic Hospital, Surabaya, and entered the ER (Resuscitation) ER room, but the patient died after being assisted for approximately two hours. Most likely the cause of the patient's death was a thromboembolic tumor in the right atrium that was released, so that it entered the bloodstream of the brain, causing the patient to have seizures. It was suspected that the cause of the patient's death was the presence of a tumor thrombus that separated into an embolism from the right atrium due to the large size of the tumor. Patients suffering from high rate NHL had a greater percentage of suffering from tumor thromboembolism as many as 10.6% compared to the Low type and Hodgkins lymphoma (LH) (5.8% and 7.25%).
Keywords
Article Details
Copyright (c) 2021 Gemilang Khusnurrokhman, Laksmi Wulandari
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
-
Folia Medica Indonesiana is a scientific peer-reviewed article which freely available to be accessed, downloaded, and used for research purposes. Folia Medica Indonesiana (p-ISSN: 2541-1012; e-ISSN: 2528-2018) is licensed under a Creative Commons Attribution 4.0 International License. Manuscripts submitted to Folia Medica Indonesiana are published under the terms of the Creative Commons License. The terms of the license are:
Attribution ” You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
NonCommercial ” You may not use the material for commercial purposes.
ShareAlike ” If you remix, transform, or build upon the material, you must distribute your contributions under the same license as the original.
No additional restrictions ” You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
You are free to :
Share ” copy and redistribute the material in any medium or format.
Adapt ” remix, transform, and build upon the material.
References
- Bligh MP, Borgaonkar JN, Burrell SC, et al (2017). Spectrum of CT findings in thoracic extranodal non-hodgkin lymphoma. Radiographics 37, 439-461.
- Diumenjo MC, Abriata G, Forman D, et al (2016). The burden of non-Hodgkin lymphoma in Central and South America. Cancer Epidemiol 44, 168-177.
- Eltawansy SA, Rao M, Ceniza S, et al (2015). Mediastinal B-cell lymphoma presenting with jugular subclavian deep vein thrombosis as the first presentation. Case Report in Vascular Medicine 2015, 1-5.
- He X, Chen Z, Fu T, et al (2014). Ki-67 is a valuable prognostic predictor of lymphoma but its utility varies in lymphoma subtypes: Evidence from a systematic meta-analysis. BMC Cancer 14, 1-13.
- National Cancer Prevention Committee (2016). Panduan penatalaksanaan LIMFOMA non Hodgkin's. Kementerian Kesehatan Republik Indonesia, Jakarta.
- Lekovic D, Miljic P, Mihaljevic B (2010). Increased risk of venous thromboembolism in patients with primary mediastinal large B-cell lymphoma. Thrombosis Research 126, 477-480.
- Mihaljevi B, Jakovi L, Jankovi S (2014). Mediastinal lymphomas - Differential diagnosis. Mil Pharm Rev 65, 166-170.
- Mohren M, Markmann I, Jentsch-Ullrich K, et al (2005). Increased risk of thromboembolism in patients with malignant lymphoma: A single-centre analysis. Br J Cancer 92, 1349-1351.
- Broaddus VC, Mason RJ, Gotway MB (eds) (2016). Murray & Nadel's textbook of respiratory medicine. 6th ed. Elsevier, Canada.
- Naeim F, Rao PN, Song S, et al (2018). Atlas of hematopathology: Morphology, immunophenotype, cytogenetics, and molecular approaches. Academic Press, United States.
- Silva M, Bankier AA, Eisenberg RL (2014). Anterior mediastinal masses. Am Roengten Ray Soc 203, 128-138.
- Singh B, Ip R, Al-Rajjal AI, et al (2016). Primary cardiac lymphoma: Lessons learned from a long survivor. Case Reports in Cardiology 2016, 1-5.
- Vincent T, DeVita Jr, Rosenberg SA, et al (2019). DeVita, Hellman and Rosenberg's cancer: Principles & practice of oncology (cancer principles and practice of oncology) 11th edition. Wolters Kluwer, United States of America.
- Young J, Goldman I (1954). Tumor metastasis to the heart. Circulation 9, 220-229.
- Kuriakose R, Melvani R, Gangadharan V, et al (2015). Right atrial metastatic melanoma with unknown primaries. Case Reports in Cardiology 2015, 1-4.
- Sweni S, Fontana M, Martinez-Naharro a A, et al (2019). Intracardiac melanoma metastases on 18F-FDG PETCT”A case report and review of literature with imaging features. BJR Case Rep 5, 1-6.
References
Bligh MP, Borgaonkar JN, Burrell SC, et al (2017). Spectrum of CT findings in thoracic extranodal non-hodgkin lymphoma. Radiographics 37, 439-461.
Diumenjo MC, Abriata G, Forman D, et al (2016). The burden of non-Hodgkin lymphoma in Central and South America. Cancer Epidemiol 44, 168-177.
Eltawansy SA, Rao M, Ceniza S, et al (2015). Mediastinal B-cell lymphoma presenting with jugular subclavian deep vein thrombosis as the first presentation. Case Report in Vascular Medicine 2015, 1-5.
He X, Chen Z, Fu T, et al (2014). Ki-67 is a valuable prognostic predictor of lymphoma but its utility varies in lymphoma subtypes: Evidence from a systematic meta-analysis. BMC Cancer 14, 1-13.
National Cancer Prevention Committee (2016). Panduan penatalaksanaan LIMFOMA non Hodgkin's. Kementerian Kesehatan Republik Indonesia, Jakarta.
Lekovic D, Miljic P, Mihaljevic B (2010). Increased risk of venous thromboembolism in patients with primary mediastinal large B-cell lymphoma. Thrombosis Research 126, 477-480.
Mihaljevi B, Jakovi L, Jankovi S (2014). Mediastinal lymphomas - Differential diagnosis. Mil Pharm Rev 65, 166-170.
Mohren M, Markmann I, Jentsch-Ullrich K, et al (2005). Increased risk of thromboembolism in patients with malignant lymphoma: A single-centre analysis. Br J Cancer 92, 1349-1351.
Broaddus VC, Mason RJ, Gotway MB (eds) (2016). Murray & Nadel's textbook of respiratory medicine. 6th ed. Elsevier, Canada.
Naeim F, Rao PN, Song S, et al (2018). Atlas of hematopathology: Morphology, immunophenotype, cytogenetics, and molecular approaches. Academic Press, United States.
Silva M, Bankier AA, Eisenberg RL (2014). Anterior mediastinal masses. Am Roengten Ray Soc 203, 128-138.
Singh B, Ip R, Al-Rajjal AI, et al (2016). Primary cardiac lymphoma: Lessons learned from a long survivor. Case Reports in Cardiology 2016, 1-5.
Vincent T, DeVita Jr, Rosenberg SA, et al (2019). DeVita, Hellman and Rosenberg's cancer: Principles & practice of oncology (cancer principles and practice of oncology) 11th edition. Wolters Kluwer, United States of America.
Young J, Goldman I (1954). Tumor metastasis to the heart. Circulation 9, 220-229.
Kuriakose R, Melvani R, Gangadharan V, et al (2015). Right atrial metastatic melanoma with unknown primaries. Case Reports in Cardiology 2015, 1-4.
Sweni S, Fontana M, Martinez-Naharro a A, et al (2019). Intracardiac melanoma metastases on 18F-FDG PETCT”A case report and review of literature with imaging features. BJR Case Rep 5, 1-6.