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英文誌(2004-)

Journal of Medical Ultrasonics

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1995 - Vol.22

Vol.22 No.11

Case Report(症例報告)

(0807 - 0811)

右室内巨大腫瘤を形成し化学療法により消失した悪性リンパ腫の1例

A Case of Malignant Lymphoma With Giant Metastatic Masses in the Right Ventricle That Disappeared After Chemotherapy

倉嶋 俊雄1, 吉岡 二郎2, 斉藤 博3

Toshio KURASHIMA1, Jiro YOSHIOKA2, Hiroshi SAITO3

1長野赤十字病院検査部, 2長野赤十字病院循環器科, 3長野赤十字病院内科

1Clinical Laboratory, Nagano Red Cross Hospital, 2Department of Cardiology, Nagano Red Cross Hospital, 3Department of Internal Medicine, Nagano Red Cross Hospital

キーワード : Cardiac metastasis , Echocardiography, Malignant lymphoma

A 61-year-old male patient with a mass of lymph nodes on the left supraclavicular fossa was transferred to this institution in November, 1993, for further examination and treatment of possibly malignant tumors. Specimens of the mass obtained by direct biopsy from the left supraclavicular fossa indicated malignant lymphoma (ML) of histologically diffuse, middle cell type of B cell origin. Systolic ejection murmur (Levine 3/6) was auscultated over the left parasternal precordial area at time of admission. ECG revealed CRBBB and negative T wave in the a VL and V1-V5 leads. Echocardiography was performed because ECG abnormalities suggested possible invasion of ML to the heart. Large abnormal masses in the pericardium that had invaded the right ventricular cavity through the anterior wall of the right ventricle were present in the right ventricle (RV). The masses appeared to divide the right ventricular cavity into two parts, and there was mid-RV obstruction. ML was judged to be in stage IV. The mass disappeared entirely after two courses of therapy with CHOP-GCSF. Clinical diagnosis of the metastatic ML of the heart in vivo is rare. The value of this case results form our having observed the process of disappearance of the masses after effective chemotherapy. Our findings suggest that echocardiography may be useful in evaluating the healing stage of ML.