Multimodality imaging in endomyocardial fibrosis associated with Hodgkin lymphoma

Multimodality imaging in endomyocardial fibrosis associated with Hodgkin lymphoma 824 Image Focus IMAGE FOCUS doi:10.1093/ehjci/jey032 Online publish-ahead-of-print 23 February 2018 .................................................................................................................................................... Multimodality imaging in endomyocardial fibrosis associated with Hodgkin lymphoma 1 1 2 2 3 Petr Kuchynka , Tomas Palecek *, Lukas Lambert , Martin Masek , and Vaclav Ptacnik 2nd Department of Medicine, Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, U Nemocnice 2, 128 08 Prague 2, Czech Republic; Department of Radiology, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, U Nemocnice 2, 128 08 Prague 2, Czech Republic; and Institute of Nuclear Medicine, First Faculty of Medicine, Charles University and General University Hospital in Prague, U Nemocnice 2, 128 08 Prague 2, Czech Republic * Corresponding author. Tel: 1 420 2 24962634; Fax: 1420 2 24912154. E-mail: tpalec@lf1.cuni.cz Endomyocardial fibrosis (EMF) repre- sents a rare type of restrictive cardiomy- opathy in Europe. This entity is of heterogeneous aetiology and is usually associated with hypereosinophilia in per- ipheral blood. We describe an unusual case of EMF associated with Hodgkin lymphoma. A 62-year-old man with a history of ax- illary lymphadenopathy and peripheral hypereosinophilia was admitted to our department for congestive heart failure. Transthoracic echocardiography showed non-dilated left ventricle with normal sys- tolic function and restrictive filling pat- tern. In the apical segments of both ventricles, obliterating pathological masses highly suspicious for EMF were present (Panel A, Supplementary data on- line, Video S1). This cardiac disorder was subsequently confirmed with cardiac magnetic resonance imaging depicting not only the pathological ventricular masses but also showing late gadolinium en- hancement pattern typical for EMF (Panel B, Supplementary data online, Video S2). To clarify the cause of hypereo- sinophilia and lymphadenopathy, positron emission tomography–computed tomography was performed and generalized lymphadenopathy typical for lymphoproliferative haematological disorder was found. Regarding the heart involvement, physiological accumulation of 18-flu- oro-deoxyglucose in the myocardium and its absence in the left ventricular mass was shown (Panel C). The patient underwent surgical extir- pation of the enlarged lymph node from the right axilla and Hodgkin lymphoma was diagnosed. After six cycles of chemotherapy including corticosteroids complete remission was observed. During this oncological treatment the amount of pathological ventricular masses signifi- cantly decreased; however, highly mobile pathological mass in the left ventricular apex was still present (Panel D, Supplementary data online, Video S3) and the patient experienced embolization to the right central retinal artery despite permanent adequate anticoagulation. In order to prevent further embolic event, surgical resection of pathological left ventricular mass was successfully performed. Supplementary data are available at European Heart Journal - Cardiovascular Imaging online. V C Published on behalf of the European Society of Cardiology. All rights reserved. The Author(s) 2018. For permissions, please email: journals.permissions@oup.com. Downloaded from https://academic.oup.com/ehjcimaging/article-abstract/19/7/824/4907938 by Ed 'DeepDyve' Gillespie user on 26 June 2018 http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png European Heart Journal – Cardiovascular Imaging Oxford University Press

Multimodality imaging in endomyocardial fibrosis associated with Hodgkin lymphoma

Free
1 page

Loading next page...
1 Page
 
/lp/ou_press/multimodality-imaging-in-endomyocardial-fibrosis-associated-with-e5QJH5J5pv
Publisher
Oxford University Press
Copyright
Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2018. For permissions, please email: journals.permissions@oup.com.
ISSN
2047-2404
D.O.I.
10.1093/ehjci/jey032
Publisher site
See Article on Publisher Site

Abstract

824 Image Focus IMAGE FOCUS doi:10.1093/ehjci/jey032 Online publish-ahead-of-print 23 February 2018 .................................................................................................................................................... Multimodality imaging in endomyocardial fibrosis associated with Hodgkin lymphoma 1 1 2 2 3 Petr Kuchynka , Tomas Palecek *, Lukas Lambert , Martin Masek , and Vaclav Ptacnik 2nd Department of Medicine, Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, U Nemocnice 2, 128 08 Prague 2, Czech Republic; Department of Radiology, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, U Nemocnice 2, 128 08 Prague 2, Czech Republic; and Institute of Nuclear Medicine, First Faculty of Medicine, Charles University and General University Hospital in Prague, U Nemocnice 2, 128 08 Prague 2, Czech Republic * Corresponding author. Tel: 1 420 2 24962634; Fax: 1420 2 24912154. E-mail: tpalec@lf1.cuni.cz Endomyocardial fibrosis (EMF) repre- sents a rare type of restrictive cardiomy- opathy in Europe. This entity is of heterogeneous aetiology and is usually associated with hypereosinophilia in per- ipheral blood. We describe an unusual case of EMF associated with Hodgkin lymphoma. A 62-year-old man with a history of ax- illary lymphadenopathy and peripheral hypereosinophilia was admitted to our department for congestive heart failure. Transthoracic echocardiography showed non-dilated left ventricle with normal sys- tolic function and restrictive filling pat- tern. In the apical segments of both ventricles, obliterating pathological masses highly suspicious for EMF were present (Panel A, Supplementary data on- line, Video S1). This cardiac disorder was subsequently confirmed with cardiac magnetic resonance imaging depicting not only the pathological ventricular masses but also showing late gadolinium en- hancement pattern typical for EMF (Panel B, Supplementary data online, Video S2). To clarify the cause of hypereo- sinophilia and lymphadenopathy, positron emission tomography–computed tomography was performed and generalized lymphadenopathy typical for lymphoproliferative haematological disorder was found. Regarding the heart involvement, physiological accumulation of 18-flu- oro-deoxyglucose in the myocardium and its absence in the left ventricular mass was shown (Panel C). The patient underwent surgical extir- pation of the enlarged lymph node from the right axilla and Hodgkin lymphoma was diagnosed. After six cycles of chemotherapy including corticosteroids complete remission was observed. During this oncological treatment the amount of pathological ventricular masses signifi- cantly decreased; however, highly mobile pathological mass in the left ventricular apex was still present (Panel D, Supplementary data online, Video S3) and the patient experienced embolization to the right central retinal artery despite permanent adequate anticoagulation. In order to prevent further embolic event, surgical resection of pathological left ventricular mass was successfully performed. Supplementary data are available at European Heart Journal - Cardiovascular Imaging online. V C Published on behalf of the European Society of Cardiology. All rights reserved. The Author(s) 2018. For permissions, please email: journals.permissions@oup.com. Downloaded from https://academic.oup.com/ehjcimaging/article-abstract/19/7/824/4907938 by Ed 'DeepDyve' Gillespie user on 26 June 2018

Journal

European Heart Journal – Cardiovascular ImagingOxford University Press

Published: Feb 23, 2018

There are no references for this article.

You’re reading a free preview. Subscribe to read the entire article.


DeepDyve is your
personal research library

It’s your single place to instantly
discover and read the research
that matters to you.

Enjoy affordable access to
over 18 million articles from more than
15,000 peer-reviewed journals.

All for just $49/month

Explore the DeepDyve Library

Search

Query the DeepDyve database, plus search all of PubMed and Google Scholar seamlessly

Organize

Save any article or search result from DeepDyve, PubMed, and Google Scholar... all in one place.

Access

Get unlimited, online access to over 18 million full-text articles from more than 15,000 scientific journals.

Your journals are on DeepDyve

Read from thousands of the leading scholarly journals from SpringerNature, Elsevier, Wiley-Blackwell, Oxford University Press and more.

All the latest content is available, no embargo periods.

See the journals in your area

DeepDyve

Freelancer

DeepDyve

Pro

Price

FREE

$49/month
$360/year

Save searches from
Google Scholar,
PubMed

Create lists to
organize your research

Export lists, citations

Read DeepDyve articles

Abstract access only

Unlimited access to over
18 million full-text articles

Print

20 pages / month

PDF Discount

20% off