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Japanese Journal of Clinical Oncology 31:217-220 (2001)
© 2001 Foundation for Promotion of Cancer Research

Complete Atrio-ventricular Block as a Major Clinical Presentation of the Primary Cardiac Lymphoma: a Case Report

Cheng-Jeng Tai1, Wei-Shu Wang1, Ming-Teng Chung2, Jin-Hwang Liu1, Chih-Yao Chiang3, Chueh-Chuan Yen1, Frank Sheng Fan1, Tzeon-Jye Chiou1 and Po-Min Chen1,+

1Division of Medical Oncology, Department of Medicine, Veterans General Hospital – Taipei and National Yang-Ming University School of Medicine, Taipei, 2Division of Pathology and 3Division of Cardiac Surgery, Department of Surgery, Cheng-Hsin Rehabilitation Medical Center, Taipei, Taiwan

It is uncommon for malignant lymphomas to present primarily with cardiac invasion as the main clinical feature. What we are interested in is not only where the disease is, but also those symptoms that it may induce. Sudden onset of complete atrio-ventricular block is one of the most common clinical presentations. Cardiac tamponade is another common disease entity which, if it locates over outlets of great vessels, may also exert symptoms of obstructive vessels. Diagnosis can be made by needle aspiration under the guidance of transcutaneous or transesophageal echocardiography. Both CT scan and MRI play positive roles in the diagnosis of cardiac lymphomas, and the latter can even provide much more image information than the former. We report a 70-year-old male with primary cardiac lymphoma with initial clinical pictures of sudden onset of complete atrio-ventricular block. Chemotherapy was utilized with cyclophosphamide, vincristine and prednisolone (COP) initially for four courses and followed by adding doxorubicin (CHOP) for another three courses. The patient was still in remission status after treatment for 2 years.

+ For reprints and all correspondence: Po-Min Chen, Division of Medical Oncology, Department of Medicine, Veterans General Hospital – Taipei, 201 Sec. 2 Shih-Pai Road, Pei-Tou, 112, Taipei, Taiwan. E-mail: cjtai@vghtpe.gov.tw


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