Image in Cardiology
Ventricular tachycardia revealing cardiac infiltration by mycosis fungoides
Taquicardia ventricular: apresentação de linfoma com infiltração cardíaca
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(B) transthoracic echocardiogram revealing left ventricular (LV) concentric hypertrophy; (C) transesophageal echocardiogram showing LV concentric hypertrophy; (D) cardiac magnetic resonance imaging revealing infiltration of the myocardium and pericardium (arrow); (E) diffuse myocardial infiltration on macroscopic post-mortem examination; (F) histologic examination (hematoxylin & eosin, ×200) revealing infiltration of the myocardium by lymphocytes; (G) histologic examination (CD3, ×200) showing CD3-positive lymphocytes; (H) histologic examination (Ki-67, ×200) revealing a high proliferative index.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 53-year-old man, with a 15-year history of mycosis fungoides (MF), presented with fever, dizziness, and presyncope. On examination, he was tachycardic (180 bpm) and hypotensive (100/70 mmHg). The ECG showed diffuse ST-segment depression, and cardiac troponin I was elevated (3.47 ng/ml). He was admitted with a suspected acute coronary syndrome.</p><p id="par0010" class="elsevierStylePara elsevierViewall">On the third day of hospitalization there were several episodes of sustained monomorphic ventricular tachycardia (MVT) (<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>A). Electric cardioversion was performed, and intravenous amiodarone was prescribed. On the following days episodes of nonsustained MVT with similar morphology were documented. Transthoracic and transesophageal echocardiography showed left ventricular (LV) concentric hypertrophy and diffuse hypokinesia (<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>B and C). Coronary angiography revealed no coronary artery disease. Cardiac magnetic resonance imaging revealed a mass infiltrating the pericardium and LV myocardium (<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>D, arrow).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">On the fifteenth day of hospitalization the patient had several episodes of sustained MVT, requiring electric cardioversion. A few hours later cardiac arrest with asystole occurred, and cardiopulmonary resuscitation was unsuccessful.</p><p id="par0020" class="elsevierStylePara elsevierViewall">Macroscopic post-mortem examination revealed diffuse myocardial infiltration (<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>E) and histological analysis confirmed infiltration by T-cell lymphoma (<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>F), with positive CD3 (<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>G) and elevated Ki-67 (<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>H), corresponding to MF stage IVB.</p><p id="par0025" class="elsevierStylePara elsevierViewall">MF is the most common cutaneous T-cell lymphoma. In advanced stages it can present nodal, visceral, or blood involvement. Cardiac involvement is rare and usually diagnosed incidentally at autopsy, as most patients have no suggestive signs or symptoms. This case demonstrates that cardiac involvement by MF may rarely manifest as MVT.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicts of interest</span><p id="par0030" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Ethical disclosures</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Protection of human and animal subjects</span><p id="par0035" class="elsevierStylePara elsevierViewall">The authors declare that no experiments were performed on humans or animals for this study.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Confidentiality of data</span><p id="par0040" class="elsevierStylePara elsevierViewall">The authors declare that they have followed the protocols of their work center on the publication of patient data.</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Right to privacy and informed consent</span><p id="par0045" class="elsevierStylePara elsevierViewall">The authors declare that no patient data appear in this article.</p></span></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Conflicts of interest" ] 1 => array:3 [ "identificador" => "sec0010" "titulo" => "Ethical disclosures" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0015" "titulo" => "Protection of human and animal subjects" ] 1 => array:2 [ "identificador" => "sec0020" "titulo" => "Confidentiality of data" ] 2 => array:2 [ "identificador" => "sec0025" "titulo" => "Right to privacy and informed consent" ] ] ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2014-01-12" "fechaAceptado" => "2014-02-02" "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1371 "Ancho" => 1900 "Tamanyo" => 431648 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(A) Telemetry tracing showing monomorphic ventricular tachycardia; (B) transthoracic echocardiogram revealing left ventricular (LV) concentric hypertrophy; (C) transesophageal echocardiogram showing LV concentric hypertrophy; (D) cardiac magnetic resonance imaging revealing infiltration of the myocardium and pericardium (arrow); (E) diffuse myocardial infiltration on macroscopic post-mortem examination; (F) histologic examination (hematoxylin & eosin, ×200) revealing infiltration of the myocardium by lymphocytes; (G) histologic examination (CD3, ×200) showing CD3-positive lymphocytes; (H) histologic examination (Ki-67, ×200) revealing a high proliferative index.</p>" ] ] ] ] "idiomaDefecto" => "en" "url" => "/21742049/0000003300000078/v2_201411090043/S2174204914001846/v2_201411090043/en/main.assets" "Apartado" => array:4 [ "identificador" => "9915" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Images in cardiology" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/21742049/0000003300000078/v2_201411090043/S2174204914001846/v2_201411090043/en/main.pdf?idApp=UINPBA00004E&text.app=https://revportcardiol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2174204914001846?idApp=UINPBA00004E" ]
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| 2018 June | 30 | 9 | 39 |
| 2018 May | 47 | 8 | 55 |
| 2018 April | 51 | 9 | 60 |
| 2018 March | 67 | 8 | 75 |
| 2018 February | 33 | 1 | 34 |
| 2018 January | 95 | 15 | 110 |
| 2017 December | 61 | 12 | 73 |
| 2017 November | 20 | 13 | 33 |
| 2017 October | 29 | 22 | 51 |
| 2017 September | 21 | 8 | 29 |
| 2017 August | 28 | 23 | 51 |
| 2017 July | 21 | 10 | 31 |
| 2017 June | 29 | 6 | 35 |
| 2017 May | 33 | 6 | 39 |
| 2017 April | 22 | 10 | 32 |
| 2017 March | 42 | 36 | 78 |
| 2017 February | 36 | 4 | 40 |
| 2017 January | 39 | 3 | 42 |
| 2016 December | 26 | 12 | 38 |
| 2016 November | 18 | 3 | 21 |
| 2016 October | 33 | 4 | 37 |
| 2016 September | 25 | 7 | 32 |
| 2016 August | 12 | 1 | 13 |
| 2016 July | 13 | 5 | 18 |
| 2016 June | 5 | 1 | 6 |
| 2016 May | 13 | 2 | 15 |
| 2016 April | 12 | 1 | 13 |
| 2016 March | 23 | 15 | 38 |
| 2016 February | 34 | 13 | 47 |
| 2016 January | 20 | 5 | 25 |
| 2015 December | 27 | 8 | 35 |
| 2015 November | 21 | 7 | 28 |
| 2015 October | 22 | 10 | 32 |
| 2015 September | 32 | 12 | 44 |
| 2015 August | 21 | 6 | 27 |
| 2015 July | 21 | 3 | 24 |
| 2015 June | 14 | 2 | 16 |
| 2015 May | 14 | 6 | 20 |
| 2015 April | 16 | 1 | 17 |
| 2015 March | 13 | 5 | 18 |
| 2015 February | 19 | 4 | 23 |
| 2015 January | 16 | 0 | 16 |
| 2014 December | 32 | 11 | 43 |
| 2014 November | 23 | 6 | 29 |
| 2014 October | 37 | 10 | 47 |
| 2014 September | 31 | 7 | 38 |
Show all
