Secondary Cardiac T-Cell Lymphoma Presenting with Syncope and Refractory Complete Atrioventricular Block: A Case Report

• Main Authors: Roya Sattarzadeh, Saeed Ghodsi, Masoud Eslami, Reza Mollazadeh, Reza Safaei Nodehi, Zahra Hosseini
• Format: Article
• Language: English
• Published: Tehran University of Medical Sciences 2020-10-01
• Series: Journal of Tehran University Heart Center
• Subjects: Lymphoma; T-cell; Syncope; Neoplasm metastasis; Atrioventricular block; Consolidation chemotherapy; Echocardiography
• Online Access: https://jthc.tums.ac.ir/index.php/jthc/article/view/1127

Cutaneous T-cell lymphomas constitute a rare category of non-Hodgkin lymphomas, which may involve the heart in the timeline of their natural course as an infrequent picture with a poor prognosis. Syncope, either due to outflow obstruction or conduction block, is also an uncommon presentation of cardiac metastasis. We herein describe a 35-year-old man, who presented with weight loss, dyspnea of 6 months’ duration, an indolent skin ulcer in the left flank, lower limb deep vein thrombosis (DVT), and recurrent syncope. He underwent implantation of a permanent pacemaker due to a complete heart block and received anticoagulants for the DVT. Skin biopsy demonstrated a T-cell lymphoma. The syncopal episodes ceased thereafter. Echocardiography and computed tomography scan revealed cardiac metastasis, which responded to systemic chemotherapy. In the first follow-up visit after 3 months, he was still pacemaker-dependent. However, the DVT was partially resolved, and the symptoms had disappeared.