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Non-Hodgkin's lymphoma: an unusual cause of myocardial infarction and hypercalcaemia
Clinical Oncology (Royal College of Radiologists (Great Britain))
|January 1, 1993
Insights
Cardiac involvement in lymphoma is often undetected. This case highlights a rare instance of non-Hodgkin
Area of Science:
- Oncology
- Cardiology
- Pathology
Background:
- Cardiac involvement occurs in 10-20% of lymphoma patients, often presenting late and difficult to diagnose.
- Hypercalcemia is a rare but serious complication of lymphoma.
Observation:
- A patient with non-Hodgkin's lymphoma rapidly developed symptomatic hypercalcemia within two weeks of diagnosis.
- The patient subsequently suffered an acute myocardial infarction three days after hypercalcemia onset.
Findings:
- Autopsy revealed unexpected coronary artery compression by lymphomatous deposits as the cause of myocardial infarction.
- This case underscores the potential for rapid, severe cardiac complications in lymphoma, even with early presentation.
Implications:
- Highlights the need for heightened clinical suspicion for cardiac complications in lymphoma patients, particularly those with hypercalcemia.
- Suggests that lymphomatous infiltration of coronary arteries can lead to acute myocardial infarction, a previously under-recognized mechanism.
- Emphasizes the importance of autopsy in identifying unusual pathological findings that can inform future clinical management.
Abstract:
Cardiac involvement is reported in 10%-20% of patients with lymphoma, but it is characteristically difficult to detect clinically or by investigation. Hypercalcaemia is a rare complication. Both complications usually occur late in the natural history of lymphoma. We report a case of non-Hodgkin's lymphoma, who, within 2 weeks of presentation, developed symptomatic hypercalcaemia and, 3 days later, died of an acute myocardial infarction. Autopsy showed, unexpectedly, the unusual finding of coronary artery compression by lymphomatous deposits.