Data Sheet 1_Case Report: Primary cardiac diffuse large B-cell lymphoma with sick sinus syndrome and literature review on disease management and therapeutic strategies.pdf

BackgroundPrimary cardiac diffuse large B-cell lymphoma (DLBCL) is a rare but clinically challenging extranodal lymphoma. Diagnosis and management are often complicated due to its nonspecific symptoms and rarity.
Case ReportWe reported a case of a 73-year-old male who initially presented with chest pain, high fever, dizziness, and amaurosis. Preliminary diagnostic assessments suggested sick sinus syndrome, necessitating the implantation of a dual-chamber pacemaker, and revealed a large mass in the interatrial septum. An endomyocardial biopsy confirmed the diagnosis of primary cardiac DLBCL. Initial treatment with R-miniCHOP chemotherapy yielded a partial response. However, due to treatment-related complications (grade 4 neutropenia and pneumonia), a change in the therapeutic regimen to OR-GemOx chemotherapy was made, leading to complete remission. A year later, the patient experienced a relapse, requiring a salvage treatment of the Pola-BR chemotherapy regimen, which again resulted in complete remission. Additionally, this review examines an in-depth literature review on the management and therapeutic strategies for this entity, focusing on the treatment recommendations for relapse/refractory disease.
ConclusionPrompt diagnosis and effective management are crucial in treating primary cardiac DLBCL. While the emergence of new drugs has improved the prognosis by offering higher efficacy and fewer side effects, clinicians should be vigilant about potential cardiotoxicities.

背景：原发性心脏弥漫大B细胞淋巴瘤（primary cardiac diffuse large B-cell lymphoma, DLBCL）是一类罕见但临床诊疗极具挑战的结外淋巴瘤。由于其症状缺乏特异性且发病率极低，诊断与治疗常面临复杂困境。
病例报告：本文报告1例73岁男性患者，初始临床表现为胸痛、高热、头晕及黑曚。初步检查提示病窦综合征，需植入双腔起搏器，同时发现房间隔存在巨大占位性肿块。心内膜活检确诊为原发性心脏DLBCL。初始予以R-miniCHOP化疗方案，患者获得部分缓解，但因出现治疗相关不良反应（4级中性粒细胞减少症合并肺炎），遂调整治疗方案为OR-GemOx化疗，后续达到完全缓解。1年后患者疾病复发，予以Pola-BR化疗方案行挽救治疗，再次获得完全缓解。此外，本文还对该疾病的诊疗策略开展了深入的文献综述，重点探讨复发/难治性病例的临床治疗推荐。
结论：及时诊断与有效管理是原发性心脏DLBCL治疗的关键环节。尽管新型药物凭借更高的疗效与更少的不良反应改善了患者预后，但临床医师仍需警惕潜在的心脏毒性风险。