Complete heart block as a complicating feature of a mediastinal lymphoma
- Vanda Cristina Jorge1,
- Vera Bernardino1,
- Ana Carolina Araújo1,
- Sara Gomes2,
- Carla Noronha1,
- Nuno Riso1,
- Manuel Vaz Riscado1
- 1Department 2, Curry Cabral’s Hospital, Lisbon, Portugal
- 2Haematology Department, Portuguese Institute of Oncology, Lisbon, Portugal
- Correspondence to Dr Vanda Cristina Jorge,
Malignant lymphomas represent about 9% of cardiac neoplasms. Despite its life-threatening nature, the cardiac manifestations are often subclinical. In about 20% of deaths from lymphoma, cardiac involvement is found only in autopsy. The authors present the case of a 77-year-old female admitted due to intense back pain, vomiting, generalised pruritus, fatigue and weight loss. She had a personal history of hypertension and breast cancer was noted 10 years before admission. The thoracoabdominopelvic CT showed a mass in the left atrium with extension to the right atrium and inferior vena cava, and a paravertebral mass at D10-D11 with invasion of the spinal canal and hepatic hilum. The transthoracic paravertebral mass biopsy was compatible with a diffuse large B cell lymphoma. The patient developed a complete atrioventricular block, with haemodynamic instability, requiring urgent chemoreduction of the paracardiac mass and implantation of an epicardial pacemaker.
Competing interests None.
Patient consent Obtained.