CARDIAC INVOLVEMENT IN HIV-RELATED NON-HODGKINS-LYMPHOMA - A CASE-REPORT AND SHORT REVIEW OF THE LITERATURE

We report a case of secondary heart involvement in AIDS-related primar y lymphoma of the liver. A worsening dyspnea led to the diagnosis of p ericardial effusion, and transesophageal echocardiography revealed the presence of large endocardial ventricular masses. Clinical suspicion of a lymphomatous origin was confirmed at the autopsy, which showed an extranodal dissemination pattern (heart, liver, intestine, and lung). In AIDS patients, both primary and secondary lymphomatous heart invol vement are increasing in incidence. Clinical symptoms and signs are va gue. Since the hematogenous route is the most common pattern of involv ement, even extrathoracic lymphomas can present heart dissemination. T hus, it should be suspected in lymphoma patients who present with even mild aspecific heart symptoms. Appropriate imaging procedures include transesophageal echocardiography and, if possible, EGG-gated MRI. A n egative transthoracic echocardiograph does not: exclude the presence o f myocardial tumor. Chemotherapy is only occasionally beneficial, and the prognosis remains poor.