Linfoma pericárdico primario con compromiso hemodinámico a propósito de un caso / Primary pericardial lymphoma with hemodynamic disorder apropos of a case

RESUMEN

RESUMEN El linfoma cardíaco primario es una enfermedad extremadamente rara y fatal del corazón. Es definido como un linfoma que compromete el corazón y el pericardio. Tiene un pronóstico pobre debido a la dificultad en su diagnóstico por lo inaccesible de su localización. Se presenta el caso de un hombre de 84 años de edad con antecedentes de salud que acudió con síntomas y signos de insuficiencia cardíaca. Se sospechó cardiopatía dilatada, pero en el ecocardiograma transtorácico se observó derrame pericárdico severo con masa adherida a la pared lateral de las cavidades derechas, sin dilatación de cavidades. Se realizó ventana pericárdica para drenar el derrame, sin poder estudiar el líquido extraído. Finalmente se realizó resonancia magnética nuclear que diagnosticó linfoma cardíaco, y teniendo en cuenta la ausencia de otras alteraciones en el resto del cuerpo, se definió como primario. No se pudo realizar diagnóstico histológico por negativa del paciente y familiares.

ABSTRACT

ABSTRACT Primary cardiac lymphoma is an extremely rare and fatal entity of the heart. It is defined as a lymphoma that compromises the heart as well as the pericardium. It has a poor prognosis because of the difficulty in its diagnosis, due to the inaccessibility of its location. Here is presented the case of an 84-year-old man with healthy history that came to our hospital with symptoms and signs of heart failure. The first suspicion was dilated cardiomyopathy, but in the transthoracic echocardiography was observed a large pericardial effusion with a mass attached to the side wall of the right chambers, without chamber dilation. A pericardial window was performed to drain the effusion, without being able to study the extracted fluid. Finally, a magnetic resonance imaging was performed resulting in a cardiac lymphoma diagnosis, that, taking into account the absence of other changes in the rest of the body, was defined as primary. No histological diagnosis could be developed due to refusal of the patient and his relatives.