Malignant lymphoma can involve the cardiac cavity or myocardium as a mass. Clinical symptoms of its cardiac involvement are usually absent or nonspecific, making the diagnosis of the cardiac involvement very difficult before death. We experienced a patient with secondary myocardial non-Hodgkin's lymphoma presenting with sustained ventricular tachycardia (VT) as a primary clinical problem. A 39-yr-old woman visited our hospital because of dyspnea and palpitation for 7 days. Physical examination revealed rapid heart beat with variable intensity of the first heart sound and soft mass in the lower abdomen. VT with a cycle length of 480 msec was recorded in resting 12-lead electrocardiogram. Two well-circumscribed hypo-echogenic round masses were demonstrated in the interventricular septum and left ventricular posterior wall. Cytological examination of aspirated pericardial fluid and percutaneous needle biopsy of the abdominal mass revealed a diffuse large cell type non-Hodgkin's lymphoma. Myocardial masses and ventricular tachycardia resolved with chemotherapy using cyclophosphamide, adriamycin, vincristine and prednisone regimen. To our best knowledge, the same case as ours has not been reported previously.
Abdominal Neoplasms/secondary ; Adult ; Biopsy, Needle ; Bundle-Branch Block ; Echocardiography ; Electrocardiography ; Female ; Heart Neoplasms/*pathology ; Humans ; Lymphoma, Non-Hodgkin/*complications/diagnosis/*pathology ; Myocardium/*pathology ; Tachycardia, Ventricular/*etiology/physiopathology

Hepatitis C virus (HCV) is one of the main viral causes of hepatocellular carcinoma (HCC) and is associated with lymphoproliferative disorder such as non-Hodgkin's lymphoma (NHL). However, there are only few case reports on concomitantly induced NHL and HCC by HCV. Herein, we report a case of synchronous NHL and HCC in a patient with chronic hepatitis C which was unexpectedly diagnosed during liver transplantation surgery. This case suggests that although intrahepatic lymph node enlargements are often considered as reactive or metastatic lymphadenopathy in chronic hepatitis C patients with HCC, NHL should also be considered as a differential diagnosis.
Antineoplastic Agents/therapeutic use ; Carcinoma, Hepatocellular/complications/*diagnosis/radiotherapy ; Drug Therapy, Combination ; Embolization, Therapeutic ; Fluorodeoxyglucose F18 ; Gadolinium DTPA ; Genotype ; Hepatitis B virus/genetics ; Hepatitis C, Chronic/complications/*diagnosis/*virology ; Humans ; Liver Neoplasms/complications/*diagnosis/radiotherapy ; Lymph Nodes/pathology ; Lymphoma, Non-Hodgkin/complications/*diagnosis/drug therapy ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Positron-Emission Tomography ; Tomography, X-Ray Computed