Sinus node dysfunction in a young patient with Hodgkin lymphoma: a case report.

Abstract

Background: Sinus node dysfunction is uncommon among bradyarrhythmias in patients with lymphomas, and it has never been reported in those with Hodgkin lymphoma (HL). We present a case of a young male diagnosed with HL who exhibited asymptomatic sinus node dysfunction.

Case summary: A 17-year-old male was diagnosed with stage IV A nodular sclerosis classic type HL. The electrocardiogram showed intermittent sinus arrest with a junctional rhythm. There was no evidence of structural changes in the right atrium (RA) walls during the initial transthoracic echocardiography evaluation. Computed tomography staging revealed multiple mediastinal adenopathies that infiltrated the cardiac level, extending into the RA and interatrial septum. The positron emission tomography scan showed metabolically active adenopathies above the diaphragm and in the upper abdomen, with nuclear uptake primarily in the RA. The patient's conduction and rhythm disorders improved during chemotherapy, highlighting the cardiac involvement linked to the underlying disease.

Discussion: To our knowledge, this is the first documented case of HL presenting with sinus node dysfunction as an early sign of cardiac involvement.