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结外 NK/T 细胞淋巴瘤晚期复发表现为肾上腺肿块并疑似心脏受累

英文原题:Late relapse of extranodal NK/T-cell lymphoma presenting as an adrenal mass with suspected cardiac involvement.

查看英文原题

Late relapse of extranodal NK/T-cell lymphoma presenting as an adrenal mass with suspected cardiac involvement.

PubMed 2025/09/08(内容时间) BMJ Case Rep Q4 · IF 0.4(JCR 2025)

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中文摘要

结外NK/T细胞淋巴瘤(ENKTCL),鼻型,是一种罕见且侵袭性强的非霍奇金淋巴瘤亚型,常表现为结外受累。虽然复发模式通常涉及鼻腔、肺部或皮肤,但心脏受累较为罕见。我们报告一例50岁晚期患者,患有ENKTCL,鼻型,在化疗和自体干细胞移植后达到完全缓解。他无病生存期6年后出现腹痛和血尿。影像学显示孤立的右侧肾上腺肿块,活检证实为复发性ENKTCL。不久后,偶然发现一个心脏肿块,累及右心房、右心室和心包。虽然不适合活检,但影像学表现出典型的冠状动脉漂浮征,这是心脏淋巴瘤的特征。尽管进行了多种治疗和姑息性努力,由于心脏受累后预后极差,患者仍去世。本病例代表了首例记录在案的复发性ENKTCL表现为心脏受累的病例。

展开英文摘要原文

Extranodal natural killer/T-cell lymphoma (ENKTCL), nasal type, is a rare and aggressive subtype of non-Hodgkin's lymphoma that often presents with extranodal involvement. While relapse patterns commonly involve the nasal cavity, lungs or skin, cardiac involvement is rare.

We report a late 50-year-old patient with ENKTCL, nasal type, who achieved complete remission following chemotherapy and autologous stem cell transplantation. He remained disease-free for 6 years before presenting with abdominal pain and haematuria. Imaging revealed an isolated right adrenal mass, confirmed as relapsed ENKTCL on biopsy. Shortly after, an incidental cardiac mass was detected, involving the right atrium, right ventricle and pericardium.

Though not amenable to biopsy, imaging exhibited the classic coronary vessel floating sign, characteristic of cardiac lymphomas. The patient passed away despite multiple therapeutic and palliative efforts due to a very poor prognosis after cardiac involvement. This case represents the first documented case of relapsed ENKTCL presenting with cardiac involvement.

论文信息

作者
Singh A、Smeltzer H、Jain S、Ananthaneni A、Ramadas P
第一作者单位
Internal Medicine, Louisiana State University Health Sciences Center Shreveport, Shreveport, Louisiana, USA.United States
通讯作者单位
Internal Medicine, Louisiana State University Health Sciences Center Shreveport, Shreveport, Louisiana, USA shubhikajn24@gmail.com.United States
文献类型
病例报告
期刊
BMJ case reports2025 Sep 8
原文标识
PubMed 40921569 · DOI 10.1136/bcr-2025-266672