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(Chest. 1994;106:1295-1299.)
© 1994 American College of Chest Physicians

Cardiac Tamponade Due to Primary Pericardial Lymphoma in a Patient With AIDS

David M. Aboulafia M.D.1; Roger Bush M.D.2; and Vincent J. Picozzi M.D.3

1 From the Sections of Hematology and Oncology; and the Division of Hematology, University of Washington, Seattle
2 From the Section of Internal Medicine, Virginia Mason Clinic, University of Washington, Seattle
3 From the Sections of Hematology and Oncology, University of Washington, Seattle

Cardiac tamponade due to lymphomatous involvement of the heart is a dramatic and unusual complication. Because of their nonspecific clinical presentation, these tumors are seldom diagnosed antemortem. We report the case of a patient with AIDS who presented with signs and symptoms of cardiac tamponade. Emergency pericardiocentesis followed by staging studies revealed large cell B-lymphocyte lymphoma confined to the pericardial space. With combination chemotherapy, a durable complete response was obtained. This case illustrates the potential benefit of aggressive treatment of extranodal non-Hodgkin's lymphoma in a patient with AIDS. The case is of particular interest because of the unusual development of isolated pericardial involvement as the sentinel sign of lymphoma.

Key Words: AIDS • cardiac tamponade • externodal lymphoma




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