A Case of Eosinophilic Myocarditis Associated with Cardiogenic Shock.

The patient was a 32-year-old man with a previous history of bronchial asthma. He was admitted with chief complaints of dyspnea and skin rash associated with itching of the palms and soles of the feet, which began 2 weeks earlier. Because of the presence of cardiac failure and increase in the peripheral blood eosinophil count, eosinophilic myocarditis (EM) was suspected. His blood pressure gradually decreased and the patient went into cardiogenic shock. Therefore, endomyocardial biopsy was performed and was immediately followed by corticosteroid therapy and intra-aortic balloon pump (IABP) placement. With the findings of eosinophil infiltration associated with myocardial interstitial edema on endomyocardial biopsy, EM was diagnosed. In this case, early therapeutic intervention led to resolution of shock resolved and improvement of the peripheral blood eosinophilia and cardiac function; the patient was discharged 33 days after the onset of symptoms. EM is a rare cardiomyopathy in which myocardial eosinophil infiltration is seen. Although it has been perceived as having a mild clinical course, this report described a severe case of EM associated with cardiogenic shock, which improved as a result of early diagnosis and therapeutic intervention.

Primary Effusion Lymphoma-like Lymphoma in a Patient with Neurofibromatosis Type 1.

To date, there are only 15 case reports of lymphoma in patients with neurofibromatosis type 1 (NF1), a common autosomal dominant tumor predisposition syndrome. Here, we present the first report of a primary effusion lymphoma (PEL)-like lymphoma (PEL-L), which is a human herpes virus 8/Kaposi sarcoma herpes virus-unrelated PEL, in a 73-year-old woman with NF1. The woman presented with pleural effusion following surgery for a small intestinal gastrointestinal stromal tumor and a malignant peripheral nerve sheath tumor. We prepared cellblocks to accurately differentiate between PEL, PEL-L, and pyothorax-associated lymphoma, for establishing a starting point for treatment and for prolonging survival. Attention should be paid to malignant neoplasms in NF1 patients. Diffuse large B-cell lymphoma may not be a rare complication in these patients, although how NF1 promotes its development remains to be determined. PEL-L should be suspected when body cavity effusion is observed in elderly patients. If feasible, it should be treated via rituximab-containing chemotherapy, which according to the literature, results in longer survival times than does drainage or regimens consisting of cyclophosphamide, doxorubicin, vincristine, and prednisone.