A Case of Primary Cardiac Lymphoma Diagnosed by Open Biopsy with Median Sternotomy.
10.4326/jjcvs.28.136
- VernacularTitle:胸骨縦切開下心筋生検にて確定診断を得たが既に部分切除も不能であった心臓原発悪性リンパ腫の一例
- Author:
Kazunori Uemura
;
Junichi Utoh
;
Ryuji Kunitomo
;
Hisashi Sakaguchi
;
Nobuo Kitamura
- Publication Type:Journal Article
- From:Japanese Journal of Cardiovascular Surgery
1999;28(2):136-139
- CountryJapan
- Language:Japanese
-
Abstract:
An 60-year-old man who initially presented with ventricular tachycardia was suspected of cardiac tumor because of localised hypertrophy of the right ventricle. Although the localized region detected by an echocardiography suggested malignancy, percutaneous transcatheter myocardial biopsy failed to obtain a histological diagnosis. Six months later, a permanent pace maker was implanted due to complete AV block. Two years after the first admission, echocardiogram and computed tomography demonstrated a cardiac tumor in the right ventricle. To obtain a histological diagnosis, open biopsy was performed under median sternotomy and showed malignant lymphoma. Antemortem diagnosis of cardiac malignancy is usually very difficult. Median sternotomy is an established procedure for cardiovascular surgeons. Open biopsy can be an acceptable technique to obtain histological diagnosis of the neoplastic region in terms of safety and simplicity, and has good sampling accuracy compared with other diagnostic modalities. We recommend early stage surgical exploration when cardiac malignancy is a diagnostic possibility.
