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Eur J Cardiothorac Surg 2001;19:365-368
© 2001 Elsevier Science NL

Case report

Cardiogenic shock due to metastatic cardiac lymphoma: still a diagnostic and therapeutic challenge

^a Department of Cardiovascular Surgery, University of Padova Medical School, Via N. Giustiniani 2, 35128 Padova, Italy
^b Department of Pathology, University of Padova Medical School, Via N. Giustiniani 2, 35128 Padova, Italy
^c Department of Anesthesiology, University of Padova Medical School, Via N. Giustiniani 2, 35128 Padova, Italy

Received 2 August 2000; received in revised form 1 December 2000; accepted 30 December 2000.

Corresponding author. Tel.: +39-049-8212411; fax: +39-049-8212409
e-mail: lucates{at}ux1.unipd.it

Myocardial involvement by metastatic lymphoma progressively leads to severe contractile impairment and fatal outcome. Correct diagnosis is often late due to misleading presentation signs. We report on a case of extensive cardiac involvement of a T-cell thymic lymphoma in a young woman, necessitating emergent extracorporeal membrane oxygenation (ECMO) circulatory support, with satisfactory hemodynamic recovery and subsequent ECMO weaning. Unfortunately, the following clinical course was rapidly fatal. This case seems to confirm that early aggressive instrumental diagnosis is crucial before severe myocardial impairment can prevent any therapeutic option. Extensive use of transesophageal echocardiographic examination and early endomyocardial biopsy are highly recommended.

Key Words: Cardiac lymphoma • Extracorporeal membrane oxygenation support • Cardiac surgery • Transesophageal echocardiography • Endomyocardial biopsy

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