A Rare Case of Cardiac Tamponade Induced by Chronic Lymphocytic Leukemia

Area of Science:

• Hematology
• Oncology
• Cardiology

Background:

• Cardiac tamponade is a known complication of solid organ malignancies and acute leukemias.
• Cardiac involvement is rarely documented in chronic hematologic malignancies, including chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL).

Observation:

• A 66-year-old male with stage IV CLL/SLL presented with worsening edema, orthopnea, and dyspnea over three weeks.
• An echocardiogram revealed a large circumferential pericardial effusion, raising concern for pericardial tamponade.
• Emergent pericardiocentesis successfully removed 700 cc of sanguineous fluid.

Findings:

• Pericardial biopsy and flow cytometry confirmed CLL/SLL involvement of the pericardium.
• No evidence of large cell lymphoma transformation was noted at the time of diagnosis.
• This case represents a rare instance of cardiac complication in the context of CLL/SLL.

Implications:

• Clinicians should consider cardiac complications, such as pericardial effusion leading to tamponade, in CLL/SLL patients presenting with symptoms like edema, orthopnea, and dyspnea.
• Early diagnosis and management of cardiac involvement are crucial for improving outcomes in CLL/SLL patients.
• This case underscores the need for heightened awareness of potential cardiac manifestations in chronic hematologic malignancies.