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T-cell prolymphocytic leukemia with extensive cardiovascular infiltrate leading to multiple myocardial infarctions

Hong Cheng, Tatyana Feldman, Yasmeen Butt

    Texas Heart Institute Journal
    |January 17, 2015
    PubMed

    Insights

    A rare case of T-cell prolymphocytic leukemia led to fatal cardiac death. Extensive leukemic infiltration of coronary arteries caused severe stenosis and myocardial infarctions.

    Area of Science:

    • Cardiology
    • Hematology
    • Oncology

    Background:

    • Lymphocytic neoplasms rarely involve the heart, typically presenting as pericardial effusion or myocardial infiltration.
    • Leukemic infiltration of coronary arteries causing myocardial infarction is exceptionally rare.

    Observation:

    • A 52-year-old man with untreated T-cell prolymphocytic leukemia developed acute cardiorespiratory failure.
    • Autopsy revealed extensive leukemic infiltration of the aorta, myocardium, and coronary arteries.
    • Severe stenosis (70-95%) in major coronary arteries led to multifocal remote myocardial infarctions.

    Findings:

    • Leukemic cells extensively infiltrated the myocardium and coronary arteries, causing significant luminal stenosis.
    • Multiple myocardial infarctions were identified, indicating severe ischemic damage.
    • Leukemia also infiltrated pulmonary and other organs.

    Implications:

    • This case highlights a rare but fatal presentation of T-cell prolymphocytic leukemia.
    • Extensive leukemic infiltration of coronary arteries can lead to acute cardiac events and death.
    • Understanding these rare cardiac manifestations is crucial for comprehensive patient management.

    Keywords:
    Aortaautopsycoronary arteriesheart neoplasms/secondary/etiologyleukemia, T-cell prolymphocyticleukemia, lymphoid/pathologymyocardial infarction

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