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

摘要

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