We report a case of malignant lymphoma of the duodenum with right atrial invasion. A 71-year-old man presented with anemia and exertional dyspnea. Gastric fibroscopy showed a duodenal tumor pathologically diagnosed as diffuse large B-cell lymphoma (DLBCL). Echocardiography showed a large right atrial tumor. We performed urgent surgery to prevent a tumor embolism. As the tumor was firmly attached to the atrium, septum and ascending aorta, we performed partial resection to improve the patient's hemodynamics status. Pathologic findings showed DLBCL. Systemic chemotherapy induced partial remission with out any cardiac recurrence.

Diagnosis of cardiac rupture caused by blunt trauma is sometimes difficult when multi-organ injuries are associated with profound shock. Only prompt diagnosis and urgent treatment can save the patients. We have encountered 16 cases of blunt cardiac rupture, including 4 that survived in the past 10 years. All cases of cardiopulmonary arrest on arrival were unable to be resuscitated. Also, all cases of profound hemorrhagic shock caused by multi-organ injury succumbed. Among the cases in which the region of cardiac rupture was identified, only cases of injury to the right heart chambers were saved. No case of rupture in the left heart chambers survived. It is definitely important to suspect cardiac injury and make a prompt diagnosis to save patients with blunt chest trauma. Ultrasonic cardiography is highly effective for urgent diagnosis of cardiac rupture because it can be performed readily, noninvasively and, therefore, repeatedly.

Prosthetic grafts have been employed in a limited number of pediatric patients with peripheral vascular lesions. We treated an iatrogenic obstruction of bilateral external iliac arteries in a child. The patient was a six-year-old girl whose chief complaints were intermittent claudication, and lower limb pain when exposed to cold. She had a history of coarctation complex for which she had undergone repeated catheterizations by puncture of both femoral arteries in her infancy. At the age of four, two-stage operation was performed: resection of the coarctation and end-to-end anastomosis, and direct closure of ventricular septal defect. Angiography performed through the brachial artery demonstrated obstruction of the bilateral external iliac arteries. Both right and left femoral artery were visualized through the collateral artery from the ipsilateral internal iliac artery. Because she became afflicted with lower limb ischemia a revascularization procedure was indicated. A 6mm expanded polytetrafluoroethylene (ePTFE) bypass graft was implanted bilaterally between the internal iliac artery and the common femoral artery with end-to-side anastomosis. Ischemic symptoms disappeared postoperatively and MR-angiogram performed nine days after surgery also showed the patency of the graft. It is a great concern, however, that the length of the graft may become relatively shorter with the growth of the patient. It is also anticipated that the lower limbs may suffer relatively insufficient blood flow in the future.

We report a case of a hemodialysis patient with a calcified amorphous tumor (CAT) located in Left ventricular outflow tract. A 69-year-old female with chronic kidney disease on hemodialysis for 10 years complained about palpitation and chest tightness. Echocardiography and cardiac MRI revealed a mobile mass in the left ventricular outflow tract (LVOT). We had a follow-up 6 months after finding mass. We thought that as the mass had potential for embolism, we should remove it; we performed an operation, tumor resection without harming the aortic valve. Her clinical course was uneventful. Pathological examination showed that the mass contained calcified nodules and fibrotic tissue. These findings showed CAT.