Progressive Heart Failure and Death as the Initial Manifestation of NK/T-Cell Lymphoma: A Case Report and Literature Review

Abstract

Natural killer/T-cell (NK/T-cell) lymphoma is a rare-type non-Hodgkin lymphoma derived from NK cells or cytotoxic T cells. Here, we present a case of a 40-year-old woman who experienced quick-developed global heart failure and then was diagnosed with NK/T-cell lymphoma through lymphoid biopsy. Neither transthoracic echocardiography nor any radiological images detected a mass in her heart or pericardium. Elevated plasma troponin level and diffused patchy areas of gadolinium late enhancement on cardiac magnetic resonance were compatible with myocarditis. Considering the persistently elevated cytokine level, systemic inflammation symptoms, acute respiratory distress syndrome, and cardiac dysfunction, a cytokine storm secondary to NK/T-cell lymphoma was considered. Due to the refractory malignant arrhythmia, the patient died soon after being admitted to our hospital.

Extranodal natural killer/T-cell lymphoma invading a patient’s heart: A rare case report and literature review

“…Whole-body PET-CT with echocardiography is indispensable in the diagnostic process of such diseases. Moreover, this type of patient has poor prognosis, often with death as the clinical outcome (Table 2) (1,(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14). These features were also seen in our reported cases.…”

Regression of Cardiac Lymphoma With Chemotherapy

“…Conversely, myocardial inflammation as the first manifestation of a lymphoproliferative process is described in some case reports, usually associated with ventricular dysfunction and its complications, such as arrhythmias 2 or heart failure 3 ; chest pain is not a common first presentation. Secondary cardiac involvement from lymphoma is a relatively frequent occurrence, reported in up to 25% of patients 4 ; this incidence is probably underestimated because of a high percentage of asymptomatic cases.…”