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Malignant lymphoma of the heart in acquired immune deficiency syndrome
Insights
Malignant lymphoma of the heart was diagnosed in two men with acquired immune deficiency syndrome (AIDS). Cardiac tumors were likely the cause of death, highlighting the need to suspect heart lymphoma in AIDS patients with cardiac symptoms.
Area of Science:
- Cardiovascular Pathology
- Oncology
- Infectious Diseases
Background:
- Acquired immune deficiency syndrome (AIDS) is associated with various opportunistic infections and malignancies.
- Cardiac manifestations in AIDS patients can be diverse, often presenting diagnostic challenges.
Observation:
- Autopsy revealed malignant lymphoma predominantly affecting the heart in two homosexual men with AIDS.
- Both patients exhibited symptoms and signs of cardiac dysfunction prior to death.
Findings:
- The lymphomas were high-grade, large cell types with plasmacytoid features, involving endocardial and myocardial tissues.
- Despite cardiac evaluations, lymphomas were diagnosed post-mortem, suggesting a de novo origin in the heart.
Implications:
- Cardiac lymphoma should be considered in the differential diagnosis of heart conditions in patients with AIDS.
- This finding underscores the importance of comprehensive cardiac assessment in advanced HIV disease.
Abstract:
Malignant lymphoma of the heart was found at autopsy of two homosexual men with acquired immune deficiency syndrome (AIDS). Both patients had symptoms and signs of cardiac dysfunction, and it is likely that the immediate cause of their deaths was related to the cardiac tumors. In both cases, there was lymphomatous involvement of other organs, but the heart was the predominant site of disease. There was prominent endocardial and myocardial involvement, and both tumors were high grade large cell lymphomas with plasmacytoid features. In both instances, the lymphomas were diagnosed only at the autopsy, despite extensive antemortem cardiac evaluation in one patient. The clinicopathologic correlation, gross pathologic and histologic findings of the tumor, and their pattern and distribution suggest a de novo origin of the lymphoma in the heart in these two patients. Lymphomatous infiltration of the heart should be suspected in patients with AIDS who have cardiac symptoms.