Arq Bras Cardiol: Imagem cardiovasc. 2022; 35(3): eabc294
Acquired Pulmonary Stenosis in an Adolescent with Lymphoma
DOI: 10.47593/2675-312X/20223503eabc294
Case report
A previously healthy 14-year-old male patient sought emergency care complaining of dyspnea. He was New York Heart Association (NYHA) functional class III and had a 1-month history of orthopnea and night sweats. Auscultation abolished in the left hemithorax, while a chest X-ray revealed extensive opacity in that region. Chest computed tomography (CT) showed a large mediastinal mass with concomitant involvement of the left pleura and retroperitoneal lymph nodes. No other palpable lymph nodes were present on physical examination.
The patient underwent pleuroscopy for pleural biopsy, which identified lymphoid cell proliferation in a “starry sky” pattern compatible with lymphoma and a histochemical pattern compatible with precursor T-cell lymphoblastic non-Hodgkin lymphoma (NHL) (pan-T and TdT, CD4 and CD4 co-expression, and high cell proliferation rate with positive Ki67 test results in 90%). Blast tests in the medulla and cerebrospinal fluid were negative.
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