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Diffuse Large B Cell Lymphoma in a Prosthetic Aortic Graft.
1Department of Cardiothoracic Surgery, Royal North Shore Hospital, Sydney, NSW, Australia.
Heart, Lung & Circulation
|September 20, 2016
Summary
A rare case of Diffuse Large B Cell Lymphoma (DLBCL) was found within aortic grafts and vessels in a Marfan Syndrome patient. This highlights DLBCL as a crucial consideration for intra-aortic thrombus in prosthetic graft patients.
Area of Science:
- Cardiovascular Surgery
- Hematology Oncology
- Vascular Medicine
Background:
- Marfan Syndrome predisposes individuals to aortic complications, necessitating interventions like the Bentall's Procedure.
- A 70-year-old man with Marfan Syndrome underwent aortic root repair 10 years prior.
- Patients with aortic grafts are at risk for thromboembolic events.
Observation:
- The patient presented with a stroke attributed to potential thrombus in the aortic arch and branch vessels.
- Imaging revealed multiple filling defects within the aorta, initially suspected as thrombus.
- Neurological symptoms partially resolved, but further embolic events were a concern.
Findings:
- Surgical aortic arch replacement was performed to mitigate embolic risk.
- Histopathology unexpectedly confirmed Diffuse Large B Cell Lymphoma (DLBCL) within the aortic graft and native aortic tissues.
- This represents an extremely rare instance of intravascular DLBCL.
Implications:
- Intravascular DLBCL should be considered in the differential diagnosis of patients presenting with intra-aortic thrombus, especially those with prosthetic grafts.
- This case underscores the importance of thorough histopathological examination of aortic pathology, even when clinical presentation suggests other etiologies.
- Early recognition and diagnosis of intravascular DLBCL are critical for appropriate management and improved patient outcomes in complex cardiovascular cases.
