Complete atrio-ventricular block: a case report of a secondary cardiac localization of an aggressive non-Hodgkinís lymphoma

Secondary lymphomatous involvement of the heart is rather common; it has been reported in 16 to 28% of lymphomas. We present a case of a 16 year-old-boy, with anaplastic B-cell CD30+ lymphoma and secondary involvement of the heart, Ann Arbor clinical stage IV AE. CT total body scan showed: a mediastinal enlargement; an abdominal mass involving the pancreas and extra-hepatic biliary tree with thickened gastric wall. On admission physical examination, cardiovascular and respiratory system, and electrocardiogram (ECG) were normal. A control ECG after two days, showed a complete atrio- ventricular block. We started chemotherapy with ProMECECytaBOM regimen. After the first chemotherapy course ECG showed normal atrio-ventricular conduction. The patient actually is alive in complete remission. We conclude that complete atrio-ventricular block may be reversible in patients with secondary cardiac localization of lymphoma; anthracycline-containing chemotherapy can be started early in these patients in spite of cardiac abnormalities.