PMID- 22343261
OWN - NLM
STAT- MEDLINE
DCOM- 20130509
LR  - 20161125
IS  - 1558-2035 (Electronic)
IS  - 1558-2027 (Linking)
VI  - 13
IP  - 12
DP  - 2012 Dec
TI  - Massive myocardial infiltration by HIV-related non-Hodgkin lymphoma: 
      echocardiographic aspects at diagnosis and at follow-up.
PG  - 836-8
LID - 10.2459/JCM.0b013e3283511fa7 [doi]
AB  - A 23-year-old male presented with severe rest dyspnoea, engorged jugular veins, 
      ankle oedema and heart rate 140 bpm. Computed tomography (CT) scan showed a large 
      mediastinal mass with pericardial and atrial infiltration, pulmonary artery and 
      superior vena cava compression. HIV infection was detected. Echocardiography 
      showed 5 x 4 cm masses both in the right and the left atria, pericardial 
      effusion, thickening of the right and left ventricular walls and hypokinesis; 
      after intravenous contrast medium (SonoVue), the ventricular myocardium showed an 
      increased, granular echogenicity, as did the mediastinal mass and pericardium. 
      Nadroparin, bisoprolol, amiodarone and (suspecting non-Hodgkin lymphoma) steroids 
      were started. After 3 days, at echocardiogram, the thickness of the ventricular 
      walls was reduced and ejection fraction was improved. Mediastinal biopsy 
      disclosed a large B-cell lymphoma. After starting systemic chemotherapy 
      (rituximab, cyclophosphamide, vincristine, doxorubicin) and highly active 
      antiretroviral therapy (HAART), 11 days after admission the patient was in New 
      York Heart Association (NYHA) class 1-2, with normal jugular veins and no oedema. 
      The echocardiogram showed no more pericardial effusion, atrial masses reduced by 
      50%, normal interventricular septum thickness and ejection fraction. In August 
      2010, after six cycles of chemotherapy followed by radiotherapy, the patient was 
      in complete remission. This case shows both the echocardiographic findings 
      typical of neoplastic infiltration of the myocardium and the rapid improvement 
      observed within a few days after chemotherapy. In the HAART era patients with 
      HIV-related lymphoma and even massive involvement of the heart may receive 
      aggressive treatment with curative intent. Echocardiography is useful in early 
      assessment of the response to therapy.
FAU - Lestuzzi, Chiara
AU  - Lestuzzi C
AD  - Cardiology Unit, National Cancer Institute, Via Gallini 2, Aviano (PN), Italy. 
      clestuzzi@cro.it
FAU - Spina, Michele
AU  - Spina M
FAU - Martellotta, Ferdinando
AU  - Martellotta F
FAU - Carbone, Antonino
AU  - Carbone A
LA  - eng
PT  - Case Reports
PT  - Journal Article
PL  - United States
TA  - J Cardiovasc Med (Hagerstown)
JT  - Journal of cardiovascular medicine (Hagerstown, Md.)
JID - 101259752
RN  - 0 (Anti-HIV Agents)
RN  - 0 (Contrast Media)
RN  - 0 (Phospholipids)
RN  - 0 (contrast agent BR1)
RN  - WS7LR3I1D6 (Sulfur Hexafluoride)
SB  - IM
MH  - Anti-HIV Agents/therapeutic use
MH  - Antineoplastic Combined Chemotherapy Protocols/therapeutic use
MH  - Antiretroviral Therapy, Highly Active
MH  - Biopsy
MH  - Contrast Media
MH  - *Echocardiography, Doppler
MH  - Humans
MH  - Lymphoma, AIDS-Related/*diagnostic imaging/therapy
MH  - Lymphoma, B-Cell/*diagnostic imaging/therapy
MH  - Male
MH  - Myocardium/*pathology
MH  - Neoplasm Invasiveness
MH  - Phospholipids
MH  - Predictive Value of Tests
MH  - Radiotherapy, Adjuvant
MH  - Sulfur Hexafluoride
MH  - Time Factors
MH  - Treatment Outcome
MH  - Young Adult
EDAT- 2012/02/22 06:00
MHDA- 2013/05/10 06:00
CRDT- 2012/02/21 06:00
PHST- 2012/02/21 06:00 [entrez]
PHST- 2012/02/22 06:00 [pubmed]
PHST- 2013/05/10 06:00 [medline]
AID - 10.2459/JCM.0b013e3283511fa7 [doi]
PST - ppublish
SO  - J Cardiovasc Med (Hagerstown). 2012 Dec;13(12):836-8. doi: 
      10.2459/JCM.0b013e3283511fa7.