心包弥漫性大b细胞淋巴瘤的计算机断层引导活检诊断

Q4 Medicine

JACC. Case reports Pub Date : 2025-09-24 DOI:10.1016/j.jaccas.2025.105070

Toshiya Yoshida MD , Midori Nanamatsu MD , Shunichi Asano MD , Takuya Narita MD, PhD , Miki Terauchi MD , Akira Hirasawa MD, PhD , Yukio Kakuta MD, PhD , Kazuhiko Yumoto MD, PhD

{"title":"心包弥漫性大b细胞淋巴瘤的计算机断层引导活检诊断","authors":"Toshiya Yoshida MD , Midori Nanamatsu MD , Shunichi Asano MD , Takuya Narita MD, PhD , Miki Terauchi MD , Akira Hirasawa MD, PhD , Yukio Kakuta MD, PhD , Kazuhiko Yumoto MD, PhD","doi":"10.1016/j.jaccas.2025.105070","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Primary pericardial lymphomas are rare. We describe a case of pericardial diffuse large B-cell lymphoma (DLBCL) diagnosed via computed tomography (CT)–guided biopsy.</div></div><div><h3>Case Summary</h3><div>A 57-year-old man presented with chest pain and weight loss for 1 month. Multiple diagnostic modalities revealed a pericardial mass with effusion. Pericardiocentesis was performed, and cytology suggested malignant lymphoma; however, the procedure was complicated by pneumothorax owing to mediastinal distortion from the pectus excavatum and minimal effusion. After multidisciplinary discussion, CT-guided biopsy was performed, which confirmed DLBCL. Polatuzumab vedotin, rituximab/cyclophosphamide, doxorubicin, and prednisone were initiated, resulting in tumor shrinkage.</div></div><div><h3>Discussion</h3><div>Early histopathological diagnosis is essential for treating malignant lymphoma. In this case, CT-guided biopsy was selected as the safest and most effective approach and was successfully performed without complications.</div></div><div><h3>Take-Home Messages</h3><div>A multidisciplinary approach is necessary for early diagnosis of pericardial lymphoma. CT-guided biopsy can be effective in certain cases.</div></div>","PeriodicalId":14792,"journal":{"name":"JACC. Case reports","volume":"30 29","pages":"Article 105070"},"PeriodicalIF":0.0000,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Pericardial Diffuse Large B-Cell Lymphoma Diagnosed Via Computed Tomography–Guided Biopsy\",\"authors\":\"Toshiya Yoshida MD , Midori Nanamatsu MD , Shunichi Asano MD , Takuya Narita MD, PhD , Miki Terauchi MD , Akira Hirasawa MD, PhD , Yukio Kakuta MD, PhD , Kazuhiko Yumoto MD, PhD\",\"doi\":\"10.1016/j.jaccas.2025.105070\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><div>Primary pericardial lymphomas are rare. We describe a case of pericardial diffuse large B-cell lymphoma (DLBCL) diagnosed via computed tomography (CT)–guided biopsy.</div></div><div><h3>Case Summary</h3><div>A 57-year-old man presented with chest pain and weight loss for 1 month. Multiple diagnostic modalities revealed a pericardial mass with effusion. Pericardiocentesis was performed, and cytology suggested malignant lymphoma; however, the procedure was complicated by pneumothorax owing to mediastinal distortion from the pectus excavatum and minimal effusion. After multidisciplinary discussion, CT-guided biopsy was performed, which confirmed DLBCL. Polatuzumab vedotin, rituximab/cyclophosphamide, doxorubicin, and prednisone were initiated, resulting in tumor shrinkage.</div></div><div><h3>Discussion</h3><div>Early histopathological diagnosis is essential for treating malignant lymphoma. In this case, CT-guided biopsy was selected as the safest and most effective approach and was successfully performed without complications.</div></div><div><h3>Take-Home Messages</h3><div>A multidisciplinary approach is necessary for early diagnosis of pericardial lymphoma. CT-guided biopsy can be effective in certain cases.</div></div>\",\"PeriodicalId\":14792,\"journal\":{\"name\":\"JACC. Case reports\",\"volume\":\"30 29\",\"pages\":\"Article 105070\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2025-09-24\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"JACC. Case reports\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2666084925018509\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"JACC. Case reports","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2666084925018509","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"Medicine","Score":null,"Total":0}

引用次数: 0

摘要

背景：原发性心包淋巴瘤是罕见的。我们报告一例心包弥漫性大b细胞淋巴瘤（DLBCL）通过计算机断层扫描（CT）引导活检诊断。病例总结男性，57岁，以胸痛、体重减轻1个月为主诉。多重诊断显示心包肿块伴积液。行心包穿刺，细胞学提示恶性淋巴瘤；然而，由于漏斗胸纵隔扭曲和少量积液导致气胸，手术变得复杂。多学科讨论后，行ct引导活检，确诊为DLBCL。开始使用Polatuzumab vedotin、利妥昔单抗/环磷酰胺、阿霉素和强的松，导致肿瘤缩小。讨论早期病理诊断对恶性淋巴瘤的治疗至关重要。在本例中，ct引导活检被认为是最安全、最有效的方法，并成功地进行了手术，无并发症。心包淋巴瘤的早期诊断需要多学科联合治疗。ct引导下的活检在某些情况下是有效的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

Pericardial Diffuse Large B-Cell Lymphoma Diagnosed Via Computed Tomography–Guided Biopsy

Background

Primary pericardial lymphomas are rare. We describe a case of pericardial diffuse large B-cell lymphoma (DLBCL) diagnosed via computed tomography (CT)–guided biopsy.

Case Summary

A 57-year-old man presented with chest pain and weight loss for 1 month. Multiple diagnostic modalities revealed a pericardial mass with effusion. Pericardiocentesis was performed, and cytology suggested malignant lymphoma; however, the procedure was complicated by pneumothorax owing to mediastinal distortion from the pectus excavatum and minimal effusion. After multidisciplinary discussion, CT-guided biopsy was performed, which confirmed DLBCL. Polatuzumab vedotin, rituximab/cyclophosphamide, doxorubicin, and prednisone were initiated, resulting in tumor shrinkage.

Discussion

Early histopathological diagnosis is essential for treating malignant lymphoma. In this case, CT-guided biopsy was selected as the safest and most effective approach and was successfully performed without complications.