CD30 positive (Ki-1) large cell lymphoma presenting with pericardial constriction

Area of Science:

• Cardiology
• Oncology
• Pathology

Background:

• Malignant lymphoma infrequently presents with cardiac involvement.
• Cardiac dysfunction due to lymphoma infiltration, particularly constrictive physiology, is exceptionally rare as an initial presentation.
• Anaplastic large cell lymphomas, especially the CD30-positive (Ki-1) subtype, have diverse clinical and pathologic features that are still being elucidated.

Purpose of the Study:

• To describe a rare case of malignant lymphoma presenting initially with severe cardiac dysfunction.
• To highlight the clinical and pathological features of a CD30-positive (Ki-1) anaplastic large cell lymphoma causing constrictive pericarditis.
• To contribute to the understanding of the cardiovascular manifestations of Ki-1 lymphomas.

Main Methods:

• Case report of a 29-year-old male patient.
• Clinical presentation and hemodynamic assessment.
• Pathological examination of cardiac tissues for lymphoma infiltration.

Main Results:

• The patient presented with profound hemodynamic impairment and rapidly fatal clinical course.
• Constrictive physiology was confirmed and attributed to diffuse infiltration of the pericardium and epicardium by Ki-1 lymphoma.
• The lymphoma was identified as a CD30-positive, T-cell type anaplastic large cell lymphoma.

Conclusions:

• Initial cardiac involvement with constrictive physiology is an uncommon but critical presentation of malignant lymphoma.
• CD30-positive (Ki-1) anaplastic large cell lymphoma can infiltrate the pericardium and epicardium, leading to fatal hemodynamic compromise.
• This case underscores the importance of considering lymphoma in the differential diagnosis of unexplained constrictive pericarditis, especially in younger patients.