[Atypical presentation of diffuse large B-cell non-Hodgkin lymphoma]. / Presentación atípica de linfoma no Hodgkin difuso de células B grandes.

The non-Hodgkin lymphoma is a neoplastic entity that presents in extranodal form in 20 % of cases, usually occurs as solitary or generalized lymphadenopathy. There may be misdiagnosis if it manifests as primary extranodal disease because the primary infiltration may occur with different organs, despite the difficulty of diagnosis of primary extranodal location of non-Hodgkin lymphoma, histological and immunohistochemical studies are effective in preventing misdiagnosis. The presentation of this case is to describe this condition in its extranodal variety with cardiac infiltration in a 23 year-old woman with progressive dyspnea. Tumor mass was detected in right-atrial, venous catheterization biopsy was performed, this enabled the histopathological diagnosis and establish treatment. We present experiences from the attention of the case and review of the literature with special reference to diagnosis and treatment.

El linfoma no Hodgkin es una entidad neoplásica que puede presentarse extraganglionarmente en el 20 % de los casos, habitualmente se presenta como linfadenopatía solitaria o generalizada. Se puede presentar error en el diagnóstico si se manifiesta enfermedad primaria extraganglionar ya que pueden presentarse con infiltración primaria a diferentes órganos, a pesar de la dificultad del diagnóstico de linfoma no Hodgkin de localización primaria extraganglionar, los estudios histológicos e inmunohistoquímicos son efectivos a la hora de evitar un diagnóstico erróneo. La presentación de este caso tiene como objetivo describir este padecimiento en su variedad extraganglionar con infiltración cardiaca en una paciente de 23 años que debutó con disnea progresiva. Se detectó una masa tumoral intraauricular derecha, por lo que se realizó biopsia por cateterismo venoso, que permitió hacer el diagnóstico histopatológico y establecer el tratamiento. Se presentan las experiencias derivadas de la atención del caso y revisión de la literatura médica con especial referencia al diagnóstico y tratamiento.

[No Hodgkin Linfoma diagnosis with intra-atrial infiltration]. / Diagnóstico de Linfoma no Hodgkin con infiltración intra-auricular.

Cardiac tumors are rare entities in clinical practice, with an incidence of 0.05%. Approximately 75% are benign and 25% malignant. Among these, Lymphomas are uncommon, representing about 0.25%. The non-Hodgkin lymphomas can occur in extranodal tissues in 20% of the cases and 80% of these non-Hodgkin lymphomas are composed of diffuse B cells. The extranodal presentation is most frequent in young adults, with a high degree of malignancy and rapid growth. It can present with primary infiltration of various organs; cardiac involvement occurs in 20 to 28% of cases, usually located in the right chambers and with nonspecific symptoms, depending on the location and extent of the tumor. The diagnostic test in these cases is undoubtedly the biopsy of the lymph node or the affected tissue. We present the case of non-Hodgkin disease of diffuse large cells, with right intra-atrial involvement in a 23-year-old-female patient, who presented with progressive dyspnea. A transesophageal echocardiography was performed and an intra-atrial tumor mass was detected. A biopsy was performed, by femoral venous catheterization, allowing the establishment of the histopathological diagnosis and treatment. At a one year follow up, the patient shows complete remission.

Diagnóstico de Linfoma no Hodgkin con infiltración intra-auricular / No Hodgkin Linfoma diagnosis with intra-atrial infiltration

Los tumores cardíacos, son entidades raras en la práctica médica, tienen una incidencia del 0,05%, aproximadamente el 75% es benigno y un 25% maligno. De estos el linfoma es infrecuente representando alrededor del 0,25%. Los linfomas no Hodgkin pueden ser extranodales en el 20% de los casos, así mismo el 80% de los linfomas no Hodgkin son de células B difusos, que es la forma más frecuente de presentación en adultos jóvenes; corresponden a alto grado de malignidad y crecimiento rápido, pueden presentarse con infiltración primaria a diferentes órganos, con afectación cardiaca en 20 a 28% de los casos y suelen localizarse en las cavidades derechas. Los síntomas son inespecíficos, dependientes de la localización y extensión del tumor y la prueba diagnóstica en estos casos es indudablemente la biopsia ya sea del ganglio linfático o del tejido afectado. Se presenta un caso de linfoma no Hodgkin difuso, de células grandes con afectación intra-auricular derecha, en una paciente de 23 años que debutó con disnea progresiva. Se realizó un ecocardiograma transesofágico que detectó una masa tumoral intra-auricular derecha, por lo que se realizó biopsia por cateterismo venoso por vía femoral, que permitió hacer el diagnóstico histopatológico y establecer el tratamiento, con lo cual se encuentra en primera remisión completa a un año del evento.

Cardiac tumors are rare entities in clinical practice, with an incidence of 0.05%. Approximately 75% are benign and 25% malignant. Among these, Lymphomas are uncommon, representing about 0.25%. The non-Hodgkin lymphomas can occur in extranodal tissues in 20% of the cases and 80% of these non-Hodgkin lymphomas are composed of diffuse B cells. The extranodal presentation is most frequent in young adults, with a high degree of malignancy and rapid growth. It can present with primary infiltration of various organs; cardiac involvement occurs in 20 to 28% of cases, usually located in the right chambers and with nonspecific symptoms, depending on the location and extent of the tumor. The diagnostic test in these cases is undoubtedly the biopsy of the lymph node or the affected tissue. We present the case of non-Hodgkin disease of diffuse large cells, with right intra-atrial involvement in a 23-year-old-female patient, who presented with progressive dyspnea. A transesophageal echocardiography was performed and an intra-atrial tumor mass was detected. A biopsy was performed, by femoral venous catheterization, allowing the establishment of the histopathological diagnosis and treatment. At a one year follow up, the patient shows complete remission.