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Secondary Cardiac Lymphoma Presenting as Effusive-Constrictive Pericarditis
Amelia Tochtrop1, Azalfa Lateef1, Will Mai2
1Department of Internal Medicine, Mayo Clinic Florida, Jacksonville, Florida, USA.
Background:
Diffuse large B-cell lymphoma (DLBCL) may present as effusive constrictive pericarditis.
Case Summary:
A 40-year-old woman with relapsed high-grade DLBCL presented with worsening dyspnea and acute decompensated heart failure. Two weeks prior, she underwent a pericardial window with preserved left ventricular ejection fraction of 50%. On admission, transthoracic echocardiography revealed nodular pericardial thickening consistent with metastatic disease and a new reduction in left ventricular ejection fraction to 39%. Doppler imaging revealed expiratory diastolic hepatic vein flow reversal, ventricular interdependence with septal bounce, and annulus reversus with a medial mitral annular e' velocity preserved at 9 cm/s and a reduced lateral e' velocity of 6 cm/s. These findings were diagnostic of effusive-constrictive pericarditis following recent pericardial drainage.
Discussion:
This case highlights secondary cardiac lymphoma as a rare cause of effusive-constrictive pericarditis and underscores the diagnostic importance of echocardiography.
Take-Home Message:
DLBCL-related pericardial involvement carries a poor prognosis with limited therapeutic options.
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