Tumor Melt: Primary Effusion Lymphoma of the Heart
A 45-year-old African-American man with a history of acquired immunodeficiency syndrome presented with exertional syncope. Other pertinent symptoms included progressive dyspnea, lower-extremity edema, poor appetite, fevers, and 60-lb weight loss. The outpatient medication regimen included tenofovir/emtricitabine, ritonavir, and atazanavir with a CD4 count of 173 and a human immunodeficiency RNA viral load of 32,783. He had a history of a right thigh Kaposi sarcoma diagnosed in 2007 but no opportunistic infections. Examination revealed fever, hypotension, tachycardia, a soft diastolic murmur, and signs of right-sided heart failure. Laboratory findings included pancytopenia and marked hypoalbuminemia (albumin 1.0, pre-albumin 5.5).
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–Peter Kriekard, MD, Joel A. Garcia, MD, Loes Nardi-Korver, MD, Mori J. Krantz, MD, FACC, FACP
–This article originally appeared in the September 2012 issue of The American Journal of Medicine.
