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      Mediastinal widening on chest radiography caused by combined aortic valve disease and primary large B-cell lymphoma

      case-report

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          Abstract

          Poststenotic aortic root dilatation in patients with aortic valvular stenosis may result in mediastinal widening on chest radiograph. Main differential diagnosis of mediastinal widening is a tumour. In fact, besides atypical chest pain or dyspnoea at exertion secondary to compression of intrathoracic structures in the latter, symptoms may be absent. We report a case of combined aortic valve disease and additional primary large B-cell lymphoma.

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          Primary non-Hodgkin's lymphoma of the mediastinum.

          Reid N. Harris, Abby Levitt, R M Linggood … (1982)
          Non-Hodgkin's lymphoma localized to the mediastinum and adjacent structures occurred in 12 of 215 (6+) non-Hodgkin's lymphoma patients seen at the Massachusetts General Hospital between 1975 and 1979. Lymphangiography, radionuclide scanning and whole body computerized tomography were used to exclude patients with extrathoracic disease at presentation. Eleven of the 12 patients presented with extensive contiguous extranodal disease (Stage IIE) with involvement of either the pericardium, sternum, chest wall, pulmonary parenchyma or, in four cases, with superior venacaval obstruction. Diffuse large cell lymphoma (eight cases) and diffuse poorly differentiated lymphocytic lymphoma (four cases) were the prevalent histologic subtypes; no instances of lymphoblastic lymphoma without extrathoracic spread were encountered. None of four lymphomas studied could be characterized as either B- or T-cell tumors utilizing conventional surface marker techniques. Ten of the 12 patients achieved complete remissions, either after treatment with combination chemotherapy alone (three patients) or after both chemotherapy and mediastinal irradiation (seven patients). Two of these ten have subsequently relapsed, but median survival has not been reached after a mean period of observation of 28 months. Primary nonlymphoblastic non-Hodgkin's lymphoma of the mediastinum is more common than previously realized, displays aggressive contiguous spread within the chest and responds well to combination chemotherapy with or without adjuvant mediastinal irradiation.
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            Doppler Echocardiographic Diagnosis and Follow-Up of Acquired Pulmonary Stenosis due to External Cardiac Compression

            Philippe Viseur, Philippe Unger (1995)
            Mediastinal tumors that cause hemodynamic disturbances by compressing the heart are extremely rare. We report the case of a 19-year-old woman who presented right ventricular outflow tract obstruction due to a non-Hodgkin lymphoma. The diagnosis of this complication and its response to chemotherapy can be accurately assessed by transthoracic echocardiography and Doppler.
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              Pulmonary stenosis caused by external compression of non-Hodgkin lymphoma.

              Otakar Belohlávek, Petr Niederle, Václav Mandys … (2004)
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                Author and article information

                Journal
                Journal ID (nlm-ta): Images Paediatr Cardiol
                Journal ID (publisher-id): IPC
                Title: Images in Paediatric Cardiology
                Publisher: Medknow Publications & Media Pvt Ltd (India )
                ISSN (Print): 1729-441X
                ISSN (Electronic): 1729-441X
                Publication date (Print): Oct-Dec 2007
                Volume: 9
                Issue: 4
                Pages: 9-14
                Affiliations
                [1 ]Division of Paediatric Cardiology, University Children's Hospital, Zurich, Switzerland
                [2 ]Division of Diagnostic Imaging, University Children's Hospital, Zurich, Switzerland
                [3 ]Division of Paediatric Oncology, University Children's Hospital, Zurich, Switzerland
                Author notes
                Contact information: Maren Tomaske, Department of Paediatric Cardiology, University Children's Hospital, Steinwiesstrasse 75, 8032 Zurich, Switzerland Phone: +41 44 266-7519 Fax: +41 44 266-7981 maren.tomaske@ 123456kispi.uzh.ch
                Article
                Publisher ID: IPC-9-9
                PMC ID: 3232583
                PubMed ID: 22368675
                SO-VID: d439ec5e-eec8-4c7b-aba7-7ae425665645
                Copyright © Copyright: © Images in Paediatric Cardiology
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Categories
                Subject: Case Report

                ScienceOpen disciplines: Cardiovascular Medicine
                Keywords: aortic valve,lymphoma b-cell,echocardiography,ventricular outflow obstruction
                Data availability:
                ScienceOpen disciplines: Cardiovascular Medicine
                Keywords: aortic valve, lymphoma b-cell, echocardiography, ventricular outflow obstruction

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