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" => "/08702551/0000003300000078/v4_201411060056/S0870255114001590/v4_201411060056/en/main.assets" "Apartado" => array:4 [ "identificador" => "29264" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Imagens em Cardiologia" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/08702551/0000003300000078/v4_201411060056/S0870255114001590/v4_201411060056/en/main.pdf?idApp=UINPBA00004E&text.app=https://revportcardiol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255114001590?idApp=UINPBA00004E" ]
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| 2019 Maio | 36 | 12 | 48 |
| 2019 Abril | 20 | 17 | 37 |
| 2019 Maro | 36 | 10 | 46 |
| 2019 Fevereiro | 50 | 13 | 63 |
| 2019 Janeiro | 73 | 3 | 76 |
| 2018 Dezembro | 70 | 13 | 83 |
| 2018 Novembro | 51 | 11 | 62 |
| 2018 Outubro | 114 | 22 | 136 |
| 2018 Setembro | 33 | 9 | 42 |
| 2018 Agosto | 29 | 14 | 43 |
| 2018 Julho | 17 | 9 | 26 |
| 2018 Junho | 20 | 6 | 26 |
| 2018 Maio | 39 | 10 | 49 |
| 2018 Abril | 32 | 7 | 39 |
| 2018 Maro | 47 | 4 | 51 |
| 2018 Fevereiro | 27 | 7 | 34 |
| 2018 Janeiro | 27 | 9 | 36 |
| 2017 Dezembro | 46 | 12 | 58 |
| 2017 Novembro | 21 | 11 | 32 |
| 2017 Outubro | 25 | 9 | 34 |
| 2017 Setembro | 26 | 8 | 34 |
| 2017 Agosto | 32 | 11 | 43 |
| 2017 Julho | 27 | 10 | 37 |
| 2017 Junho | 27 | 13 | 40 |
| 2017 Maio | 33 | 9 | 42 |
| 2017 Abril | 14 | 1 | 15 |
| 2017 Maro | 27 | 2 | 29 |
| 2017 Fevereiro | 20 | 4 | 24 |
| 2017 Janeiro | 24 | 3 | 27 |
| 2016 Dezembro | 18 | 4 | 22 |
| 2016 Novembro | 16 | 3 | 19 |
| 2016 Outubro | 14 | 6 | 20 |
| 2016 Setembro | 14 | 5 | 19 |
| 2016 Agosto | 10 | 4 | 14 |
| 2016 Julho | 7 | 8 | 15 |
| 2016 Junho | 1 | 0 | 1 |
| 2016 Maio | 14 | 11 | 25 |
| 2016 Abril | 14 | 2 | 16 |
| 2016 Maro | 33 | 6 | 39 |
| 2016 Fevereiro | 49 | 16 | 65 |
| 2016 Janeiro | 34 | 8 | 42 |
| 2015 Dezembro | 42 | 8 | 50 |
| 2015 Novembro | 26 | 7 | 33 |
| 2015 Outubro | 28 | 6 | 34 |
| 2015 Setembro | 45 | 11 | 56 |
| 2015 Agosto | 49 | 9 | 58 |
| 2015 Julho | 33 | 7 | 40 |
| 2015 Junho | 30 | 6 | 36 |
| 2015 Maio | 28 | 5 | 33 |
| 2015 Abril | 36 | 16 | 52 |
| 2015 Maro | 23 | 4 | 27 |
| 2015 Fevereiro | 22 | 11 | 33 |
| 2015 Janeiro | 25 | 9 | 34 |
| 2014 Dezembro | 24 | 16 | 40 |
| 2014 Novembro | 37 | 19 | 56 |
| 2014 Outubro | 50 | 22 | 72 |
| 2014 Setembro | 68 | 48 | 116 |
Mostrar tudo
