急性右心不全の発症を契機に発見された原発性心臓悪性リンパ腫の1例

Successful Surgical Treatment of Primary Cardiac Lymphoma Detected with the Onset of Acute Heart Failure；Report of a Case

原発性心臓悪性リンパ腫（PCL）はまれな悪性腫瘍であり，組織学的にはB細胞腫瘍が多い．一般的には無症候であるため発見が遅れることが多く，予後不良で，外科切除術の施行例は少ない．われわれはPCLの手術症例を経験したので報告する．

A 83-year-old woman, suffering from rapidly worsening dyspnea and weight gain from a week ago, was referred for evaluation and treatment of cardiac tumor in the right atrium. Echocardiography and enhanced computed tomography revealed a large tumor, more than 6 cm, occupying the right atrium and blocking the tricuspid valve inflow. Electrocardiogram showed bradycardiac atrial fibrillation. We performed partial resection with cardiopulmonary bypass, in order to improve hemodynamics and to make a definite diagnosis. In operation, the tumor infiltrated not only the right atrium but also the right ventricle and the tricuspid annulus. The pathological examination suggested malignant lymphoma, diffuse large B-cell type. The patient was treated chemotherapy postoperatively. She is alive 1 year after the surgery without apparent recurrence.