Posters
Presentation Type
Poster
Discipline Track
Patient Care
Abstract Type
Case Report
Abstract
Background: Mediastinal masses can arise from typical structures within the mediastinal or they can develop secondary to metastasis from other organ systems [1] Primary mediastinal diffuse large B-Cell lymphomas (PMBCL) are uncommon, accounting for 7% of the cases of diffuse large b cell lymphoma. We describe a case of a 35-year-old woman who presented with atypical chest pain and shortness of breath and was diagnosed with PMBCL in the setting of impending cardiac tamponade.
Case Report: A 35-year-old woman with history of cutaneous lupus presented with an 8-month history of chest pain with associated worsening shortness of breath. Upon further questioning, the patient reported having night sweats intermittently with an associated 10-lb weight loss. On examination, patient was tachycardic to 140 BPM, dyspneic with SPO2 99% on room air, with a BP of 137/87 mm/Hg.
Results: CXR was performed which showed a widened mediastinum and cardiomegaly. LDH 514 IU/L. Echocardiogram was performed which revealed a large mediastinal tumor, pericardial effusion with suspicion of possible diastolic compromise. Patient was taken to OR for an emergent pericardial window and biopsy of the mass. Pathology along with immunostaining positive for CD45, CD20, Bcl1, Bcl6 correlated with a diagnosis of PMBCL.
Conclusions: PMBCL can be aggressive but tend to have similar response rates compared to other types of b cell lymphomas when combination chemotherapy and mediastinum irradiation is initiated [3]. Our patient opted to be transferred to MD Anderson for higher level of care. Patient is scheduled to follow-up with the oncology team soon.
Academic/Professional Position
Resident
Academic/Professional Position (Other)
PGY1
Mentor/PI Department
Internal Medicine
Recommended Citation
Loftis, Christine E.; Guedez-White, Rosa; and Farray, Daniel, "My Achy-Breaky Heart: A Case of Diffuse Large B-Cell Lymphoma Presenting as Impending Cardiac Tamponade in a Hispanic Woman" (2023). Research Symposium. 71.
https://scholarworks.utrgv.edu/somrs/theme1/posters/71
Included in
My Achy-Breaky Heart: A Case of Diffuse Large B-Cell Lymphoma Presenting as Impending Cardiac Tamponade in a Hispanic Woman
Background: Mediastinal masses can arise from typical structures within the mediastinal or they can develop secondary to metastasis from other organ systems [1] Primary mediastinal diffuse large B-Cell lymphomas (PMBCL) are uncommon, accounting for 7% of the cases of diffuse large b cell lymphoma. We describe a case of a 35-year-old woman who presented with atypical chest pain and shortness of breath and was diagnosed with PMBCL in the setting of impending cardiac tamponade.
Case Report: A 35-year-old woman with history of cutaneous lupus presented with an 8-month history of chest pain with associated worsening shortness of breath. Upon further questioning, the patient reported having night sweats intermittently with an associated 10-lb weight loss. On examination, patient was tachycardic to 140 BPM, dyspneic with SPO2 99% on room air, with a BP of 137/87 mm/Hg.
Results: CXR was performed which showed a widened mediastinum and cardiomegaly. LDH 514 IU/L. Echocardiogram was performed which revealed a large mediastinal tumor, pericardial effusion with suspicion of possible diastolic compromise. Patient was taken to OR for an emergent pericardial window and biopsy of the mass. Pathology along with immunostaining positive for CD45, CD20, Bcl1, Bcl6 correlated with a diagnosis of PMBCL.
Conclusions: PMBCL can be aggressive but tend to have similar response rates compared to other types of b cell lymphomas when combination chemotherapy and mediastinum irradiation is initiated [3]. Our patient opted to be transferred to MD Anderson for higher level of care. Patient is scheduled to follow-up with the oncology team soon.