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Cardiac involvement with lymphoma/leukemia: a report of three autopsy cases
1Division of Pathology, Faculty of Medical Sciences, University of the West Indies, St. Augustine.
Insights
This study describes cardiac involvement in adult T-cell leukemia/lymphoma (ATL) and promyelocytic leukemia. Despite extensive disease, cardiac symptoms were absent ante-mortem, highlighting subtle lymphoma and leukemia cardiac infiltration.
Area of Science:
- Oncology
- Hematology
- Pathology
Background:
- Adult T-cell leukemia/lymphoma (ATL) and promyelocytic leukemia are aggressive hematologic malignancies.
- Cardiac involvement in these leukemias is uncommon and often clinically silent.
- Human T-lymphotropic virus type I (HTLV-I) is associated with ATL.
Observation:
- Clinicopathological findings in three patients (two with ATL, one with promyelocytic leukemia) with cardiac involvement are presented.
- Two ATL patients and one promyelocytic leukemia patient tested positive for HTLV-I; one ATL patient was also HIV-positive.
- Cardiac infiltration ranged from microscopic foci to macroscopic lesions mimicking myocardial infarction in ATL, and microabscesses in promyelocytic leukemia.
Findings:
- All three patients exhibited extensive malignant disease with multi-organ infiltration.
- No ante-mortem cardiac manifestations were observed in any of the cases.
- Cardiac dimensions remained within normal limits despite significant myocardial infiltration.
Implications:
- The study highlights the potential for asymptomatic cardiac infiltration by ATL and promyelocytic leukemia.
- Understanding the pathophysiology of cardiac involvement is crucial for comprehensive patient management.
- Further research is needed to elucidate the mechanisms and clinical significance of leukemia/lymphoma cardiac infiltration.
Abstract:
The clinicopathological findings in two patients with ATL and one patient with promyelocytic Leukemia affecting the heart are described. All three cases tested positive for HTLV-I while one of the ATL cases was also positive for HIV. Cardiac infiltrate in the ATL cases varied from microscopic focii in one case to macroscopic infiltration mimicking myocardial infarction in the other case. There were microabscesses in the myocardium in the case afflicted with promyelocytic Leukemia. All three cases had extensive malignant disease with multiple organ infiltration. There was no ante-mortem manifestation of cardiac involvement in any case. The cardiac dimensions were all within the normal range. The possible pathophysiology of cardiac involvement with Lymphoma/Leukemia is discussed.
