Pericardial constriction due to malignant lymphoma

We experienced a case of T-cell lymphoma demonstrating diastolic heart fail ure as an initial manifestation. An 81-year-old Japanese male was admitted to the University of Tokyo Hospital because of progressive dyspnea and gene ral fatigue. Clinical presentation was congestive heart failure and cervica l lymphadenopathy. Right heart catheterization revealed "dip and plateau" w aveforms in right ventricular pressure, which suggested a constrictive natu re of heart failure. Gallium scintigram showed marked uptake in the heart. Biopsy from a cervical lymph node confirmed the diagnosis of malignant lymp homa of T-cell origin. Diastolic heart failure remained after successful ch emotherapy. Autopsy revealed pericarditis with severe adhesion of the peric ardium and the epicardium.