Diagnóstico de Linfoma no Hodgkin con infiltración intra-auricular

2012 
Los tumores cardiacos, son entidades raras en la practica medica, 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, asi mismo el 80% de los linfomas no Hodgkin son de celulas B difusos, que es la forma mas frecuente de presentacion en adultos jovenes; corresponden a alto grado de malignidad y crecimiento rapido, pueden presentarse con infiltracion primaria a diferentes organos, con afectacion cardiaca en 20 a 28% de los casos y suelen localizarse en las cavidades derechas. Los sintomas son inespecificos, dependientes de la localizacion y extension del tumor y la prueba diagnostica en estos casos es indudablemente la biopsia ya sea del ganglio linfatico o del tejido afectado. Se presenta un caso de linfoma no Hodgkin difuso, de celulas grandes con afectacion intra-auricular derecha, en una paciente de 23 anos que debuto con disnea progresiva. Se realizo un ecocardiograma transesofagico que detecto una masa tumoral intra-auricular derecha, por lo que se realizo biopsia por cateterismo venoso por via femoral, que permitio hacer el diagnostico histopatologico y establecer el tratamiento, con lo cual se encuentra en primera remision completa a un ano del evento.(AU) 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.(AU)
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