Cardiac Involvement as First Manifestation of Peripheral T-Cell Not Otherwise Specified Lymphoma

Area of Science:

• Oncology
• Cardiology
• Pathology

Background:

• Peripheral T-cell lymphoma not otherwise specified (PTCL-NOS) rarely presents with cardiac involvement as the initial manifestation.
• Cardiac PTCL-NOS is associated with an aggressive clinical course and diagnostic challenges.

Purpose of the Study:

• To report a rare case of PTCL-NOS presenting initially with cardiac manifestations.
• To emphasize the diagnostic challenges and treatment difficulties in such cases.

Main Methods:

• Case report of a 72-year-old male with hypertension, dyslipidemia, and prediabetes.
• Clinical presentation included acute pleuropericarditis, pericardial effusion, and conduction abnormalities.
• Diagnosis was confirmed via biopsy showing PTCL-NOS (CD3+, CD5+, CD7+, high Ki-67), with imaging revealing pericardial/myocardial infiltration and a right atrial mass.

Main Results:

• The patient experienced disease progression despite initial treatments.
• Complications included ileus, pulmonary embolism, and neutropenia.
• Standard chemotherapy regimens (CHOP, GemOx) were ineffective, leading to a fatal outcome from hypernatremia.

Conclusions:

• Cardiac PTCL-NOS presents significant diagnostic challenges, often requiring advanced imaging and multidisciplinary collaboration.
• The aggressive nature of this condition and poor response to conventional therapies underscore the need for novel treatment strategies.