右心房非霍奇金淋巴瘤一例并文献复习

A Case of Non-Hodgkin’s Lymphoma in the Right Atrium and Literature Review

摘要: 目的：通过对心脏非霍奇金淋巴瘤的病例报道，提高对心脏肿瘤相关疾病的认识。方法：报道1例心脏继发性非霍奇金淋巴瘤的临床表现及诊治过程，并对常见心脏肿瘤的临床及影像学特点进行文献回顾。结果：该例患者以反复胸闷、憋气伴全身水肿来诊，予以完善心脏超声示右心房占位，经手术治疗，术后病理诊断为：(右心房)大B细胞淋巴瘤–弥漫性大B细胞淋巴瘤，非特殊型；Hans分类：生发中心型；免疫组化结果示：CD20(+)，Ki67(80%+)，BCL2(+)，BCL6(+)，p53(野生型)，PAXS(+)，CD19(+)，分子病理检查结果示：EBBR-ISH(−)。PETCT示淋巴瘤累及右心房壁、上腔静脉壁及直肠末段，现患者于血液科行化疗治疗。结论：对于全身水肿的患者，应积极完善心脏超声等相关检查，评估心脏结构及功能是否存在异常，对于心脏肿瘤，早期的诊断与治疗对患者的预后具有重大意义。

Abstract: Objective: To improve the understanding of cardiac tumor related diseases through case reports of non-Hodgkin’s lymphoma in the heart. Method: Report the clinical manifestations, diagnosis and treatment of a case of secondary non-Hodgkin’s lymphoma of the heart, and review the literature on the clinical and imaging characteristics of common cardiac tumors. Result: The patient was diag-nosed with recurrent chest tightness, suffocation, and systemic edema, and was diagnosed with a right atrial mass on echocardiography. After surgical treatment, the postoperative pathological di-agnosis was: (right atrium) large B-cell lymphoma diffuse large B-cell lymphoma, non-specific type; Hans classification: germinal center type; The immunohistochemical results showed CD20 (+), Ki67 (80%+), BCL2 (+), BCL6 (+), p53 (wild-type), PAXS (+), CD19 (+), and the molecular pathological examination results showed EBBR-ISH (−). PETCT showed lymphoma involving the right atrial wall, superior vena cava wall, and distal rectum. The patient is currently undergoing chemotherapy treatment in the hematology department. Conclusion: For patients diagnosed with systemic edema, it is necessary to actively improve cardiac ultrasound and other related examinations to evaluate whether there are abnormalities in cardiac structure and function. For cardiac tumors, early diag-nosis and treatment are of great significance for the prognosis of patients.