MALIGNANT-LYMPHOMA AND COLONIC-CARCINOMA 3 YEARS AFTER HEART-TRANSPLANTATION AND IMMUNOSUPPRESSION

Three years after heart transplantation and immunosuppressive therapy, a 66-year-old man suffered from dyspnea and showed symptoms mainly du e to right heart failure. Malignant tumor cells were discovered within extensive pleural effusion. Computed tomography revealed two lesions of the liver suspicious of metastases, and recurrent blood in the stoo ls was evident. The patient deteriorated rapidly and died 3 weeks afte r admission. Autopsy findings included an adenocarinoma of the cecum ( grade II) with metastases to the liver. High-grade immunoblastic non-H odgkin's lymphoma of plasmoblastic differentiation was diagnosed, loca ted within the mediastinal soft tissues and infiltrating the peri- and myocardium. Mesenteric lymph nodes were enlarged with histological ve rification of malignant lymphoma. The lymphatic tumor masses had cause d considerable compression of the heart and vessels, leading to the si gns of cardiac failure. The development of metastasizing colonic carci noma and high-grade immunoblastic non-Hodgkin's lymphoma 3 years after heart transplantation and immunosuppressive therapy must be considere d an unusual combination. Malignent lymphomas following heart transpla ntation have been described several times.