T-cell prolymphocytic leukemia with extensive cardiovascular infiltrate: Leading to multiple myocardial infarctions and cardiac death

Hong Cheng, Tatyana Feldman, Yasmeen Butt, Kar F. Chow, Xiao Yan Yang, Pritish K. Bhattacharyya, David C. De Vinck

Research output: Contribution to journalArticle

4 Scopus citations

Abstract

Lymphocytic neoplasm involving the heart is not common and usually presents with pericardial effusion or focal myocardial infiltration. Myocardial infarctions due to leukemic infiltration of the coronary arteries are rarely reported. We present the case of a 52-year-old Guatemalan man with a one-year history of untreated T-cell prolymphocytic leukemia. He was admitted to our hospital for chemotherapy and evaluation of a pulmonary cavitary lesion by wedge resection. During sedation, the patient experienced acute respiratory failure and hypovolemic shock, from which he could not be resuscitated. Autopsy revealed that leukemic cells extensively infiltrated the aorta, myocardium, and coronary arteries. The lumina of the 3 major coronary artery branches showed 70% to 95% stenosis, with multifocal remote myocardial infarctions. Tumor cells were also detected in the lungs and other organs. The acute cardiorespiratory insufficiency secondary to leukemia—particularly the extensive infiltration of the coronary arteries and myocardium, and the multiple myocardial infarctions—eventually resulted in cardiac death.

Original languageEnglish (US)
Pages (from-to)626-630
Number of pages5
JournalTexas Heart Institute Journal
Volume41
Issue number6
DOIs
StatePublished - Dec 1 2014

Keywords

  • Aorta
  • Autopsy
  • Coronary arteries
  • Heart neoplasms/secondary/etiology
  • Leukemia
  • Leukemia
  • Lymphoid/pathology
  • Myocardial infarction
  • T-cell prolymphocytic

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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