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Multifocal precursor B-cell lymphoblastic lymphoma in an infant with cardiac involvement: A case report
Tran Phan Ninh1,2, Nguyen Minh Duc3,4, Nguyen Ngoc Trung5
1Department of Radiology, National Hospital of Pediatrics, Ha Noi, Vietnam.
Insights
This case report details a rare multifocal precursor B-cell lymphoblastic lymphoma in a child with cardiac involvement. Early diagnosis via combined imaging led to successful chemotherapy treatment.
Area of Science:
- Pediatric Oncology
- Cardiovascular Pathology
- Diagnostic Imaging
Background:
- Cardiac involvement in pediatric lymphoma is a high-risk indicator.
- Precursor B-cell lymphoblastic lymphoma can present multifocally.
- Early detection is crucial for improving outcomes in pediatric lymphoma.
Observation:
- A 4-year-old boy presented with non-specific symptoms and normal initial head imaging.
- Subsequent development of chest pain, dyspnea, and abdominal pain prompted further investigation.
- Imaging revealed a right atrial mass, small bowel intussusception, and mesenteric lymphadenopathy.
Findings:
- Histopathology confirmed multifocal precursor B-cell lymphoblastic lymphoma.
- Cardiac involvement was identified as a significant mass in the right atrial wall.
- Multifocal disease was also present in the small bowel and mesenteric lymph nodes.
Implications:
- Combined imaging modalities (echocardiography, CT, ultrasound) are vital for diagnosing complex pediatric lymphoma cases.
- Prompt diagnosis and multi-site identification facilitated effective chemotherapy.
- This case underscores the importance of a comprehensive diagnostic approach for pediatric lymphoma with suspected cardiac involvement.
Abstract:
Lymphoma with cardiac involvement is a high-risk lesion, especially in children. We report a rare clinical case of multifocal precursor B-cell lymphoblastic lymphoma in a child with cardiac involvement. A 4-year-old boy presented to the Vietnam National Children's Hospital with a vague headache, but magnetic resonance imaging of the head was normal. After 1 week, the patient showed symptoms of chest pain, fatigue, dyspnea, and abdominal pain. On transthoracic echocardiography and multislice computed tomography of the thorax, a mass was detected in the right atrial wall. Abdominal ultrasound showed a small bowel intussusception, multiple nodules in the intestinal wall, and mesenteric lymph nodes. Histopathology of the bowel confirmed the diagnosis of multifocal precursor B-cell lymphoblastic lymphoma. The patient responded to 3 cycles of chemotherapy for lymphoma. Therefore, combining multiple imaging methods allowed for early diagnosis and improved treatment.
