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A fatal case of acute pulmonary embolism caused by right ventricular masses of acute lymphoblastic lymphoma-leukemia in a 13 year old girl.
MedLine Citation:
PMID:  22844319     Owner:  NLM     Status:  PubMed-not-MEDLINE    
Abstract/OtherAbstract:
We report a case of a 13-year-old girl with acute lymphoblastic lymphoma-leukemia, who presented with a cardiac metastasis in the right ventricle, resulting in a pulmonary embolism. At the time of her leukemia diagnosis, a cardiac mass was incidentally found. The differential diagnosis for this unusual cardiac mass included cardiac tumor, metastasis, vegetation, and thrombus. Empirical treatment was initiated, including anticoagulation and antibiotics. She underwent plasmapheresis and was administered oral prednisolone for her leukemia. Five days later, she experienced sudden hemodynamic collapse and required extracorporeal membrane oxygenation insertion and emergency surgery. These interventions proved futile, and the patient died. Pathology revealed that the cardiac mass comprised an aggregation of small, round, necrotic cells consistent with leukemia. This is the first known case of acute lymphoblastic leukemia presenting as a right ventricular mass, with consequent fatal acute pulmonary embolism. A cardiac mass in a child with acute leukemia merits investigation to rule out every possible etiology, including vegetation, thrombus, and even a mass of leukemic cells, which could result in the fatal complication of pulmonary embolism.
Authors:
Yu Mi Ko; Soo Hyun Lee; June Huh; Hong Hoe Koo; Ji Hyuk Yang
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Publication Detail:
Type:  Journal Article     Date:  2012-07-17
Journal Detail:
Title:  Korean journal of pediatrics     Volume:  55     ISSN:  2092-7258     ISO Abbreviation:  Korean J Pediatr     Publication Date:  2012 Jul 
Date Detail:
Created Date:  2012-07-30     Completed Date:  2012-10-02     Revised Date:  2013-05-30    
Medline Journal Info:
Nlm Unique ID:  101215374     Medline TA:  Korean J Pediatr     Country:  Korea (South)    
Other Details:
Languages:  eng     Pagination:  249-53     Citation Subset:  -    
Affiliation:
Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
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