A VEXING RECURRENT PERICARDIAL EFFUSION WITHOUT UNDERLYING PATHOLOGY – SUBSEQUENT DIAGNOSIS OF LYMPHOMA PROVES A RARE FIRST PRESENTATION

Authors

  • Haseeb Ur Rahman Nevill Hall Hospital, Abergavenny Aneurin Bevan University Health Board
  • Saad Hasan Nevill Hall Hospital, Abergavenny Aneurin Bevan University Health Board
  • Stephen Hutchison Nevill Hall Hospital, Abergavenny Aneurin Bevan University Health Board

Abstract

An elderly man had recurrent admissions with large symptomatic pericardial effusions. Initial computed tomography (CT) of thorax, abdomen and pelvis and pericardial fluid analysis did not reveal underlying cause. On subsequent presentation, pericardial window was formed but repeat pericardial fluid analysis and biopsy failed to give a diagnosis again. He then presented approximately after four months with worsening symptoms of dyspnoea and weight loss. General physical examination at that point noted inguinal lymphadenopathy. Repeat imaging with CT and magnetic resonance imaging (MRI) showed features of metastatic malignancy. Tissue diagnosis from inguinal lymph nodes proved to be diffuse large B-cell lymphoma (DLBCL).Keywords: pericardial effusion; inguinal lymphadenopathy; diffuse large B-cell lymphoma

Author Biographies

Haseeb Ur Rahman, Nevill Hall Hospital, Abergavenny Aneurin Bevan University Health Board

Cardiology Core Trainee

Saad Hasan, Nevill Hall Hospital, Abergavenny Aneurin Bevan University Health Board

Cardiology Specialty Registrar

Stephen Hutchison, Nevill Hall Hospital, Abergavenny Aneurin Bevan University Health Board

Consultant Cardiologist

References

Giudicatti LC, Cirillo M, King B. Pericardial effusion as first presentation of disseminated non-Hodgkin’s lymphoma. BMJ Case Rep 2018;2018:bcr2018225926.

Gordon MJ, Danilova O, Spurgeon S, Danilov AV. Cardiac non‐Hodgkin's lymphoma: clinical characteristics and trends in survival. Eur J Haematol 2016;97(5):445–52.

Mumoli N, Cei M, Gambaccini L, Sabatini S, Vitale J. Hodgkin disease complicated by recurrent cardiac tamponade, QJM 2013;106(9):859–60.

Imazio M, Mayosi BM, Brucato A, Markel G, Trinchero R, Spodick DH, et al. Triage and management of pericardial effusion, J Cardiovasc Med 2010;11(12):928–35.

Beck CS. Two cardiac compression triads. JAMA 1935;104(9):714–6.

Published

2020-07-19

Issue

Vol. 32 No. 3 (2020): JOURNAL OF AYUB MEDICAL COLLEGE, ABBOTTABAD

Section

CASE REPORT

License

Journal of Ayub Medical College, Abbottabad is an OPEN ACCESS JOURNAL which means that all content is FREELY available without charge to all users whether registered with the journal or not. The work published by J Ayub Med Coll Abbottabad is licensed and distributed under the creative commons License  CC BY ND Attribution-NoDerivs. Material printed in this journal is OPEN to access, and are FREE for use in academic and research work with proper citation. J Ayub Med Coll Abbottabad accepts only original material for publication with the understanding that except for abstracts, no part of the data has been published or will be submitted for publication elsewhere before appearing in J Ayub Med Coll Abbottabad. The Editorial Board of J Ayub Med Coll Abbottabad makes every effort to ensure the accuracy and authenticity of material printed in J Ayub Med Coll Abbottabad. However, conclusions and statements expressed are views of the authors and do not reflect the opinion/policy of J Ayub Med Coll Abbottabad or the Editorial Board.

USERS are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles, or use them for any other lawful purpose, without asking prior permission from the publisher or the author. This is in accordance with the BOAI definition of open access.

AUTHORS retain the rights of free downloading/unlimited e-print of full text and sharing/disseminating the article without any restriction, by any means including twitter, scholarly collaboration networks such as ResearchGate, Academia.eu, and social media sites such as Twitter, LinkedIn, Google Scholar and any other professional or academic networking site.