S-194 : A case of huge primary cardiac lymphoma causing hypoxemic respiratory failure = S-194 : A case of huge primary cardiac lymphoma causing hypoxemic respiratory failure

다국어 초록 (Multilingual Abstract)

Introduction: Primary cardiac lymphomas are rare extranodal lymphomas. Its clinical manifestations are variable. Here, we report an 82-year-old man with acute hypoxemic respiratory failure who had a tumor in the right atrium. Case: An 82-year-old man was admitted to an hospital with severe shortness of breath. He was in New York Heart Association class IV, on the basis of symptoms. On the arterial blood gas analysis, the pH was 7.47, PaCO2 31.9 mmHg, PaO2 41 mmHg, HCO3 23.7 mmol/L and SaP2 81% with reservoir mask 15L. The Chest PA showed bulging contour of right cardiac border. Transthoracic echocardiography & chest computed tomographic scan reveals huge right atrial mass. The patient was referred for surgical excision. At surgery, there was 8×10 cm mass arised from anterolateral right atrial free wall, and another 3×4 cm mass at antero-inferior free wall. On H & E stain, the tumor shows diffuse proliferation of large atypical lymphoid cells showing centroblastic or plasmacytic differentiation. Diffuse large B-cell lymphoma was diagnosed. Postoperative echocardiography revealed no abnormal mass lesion. After surgery, he was in in NYHA class I and discharged. Discussion: Acute hypoxemic respiratory failure is severe arterial hypoxemia that is refractory to supplemental O2. Acute hypoxemic respiratory failure caused by a variety of different medical problems, and despite its rarity, malignant lymphoma should be considered in the differential diagnosis of acute hypoxemic respiratory failure.