Acute Appendicitis Concurrent with Cardiac Anaplastic Large Cell Lymphoma Volume 6 - Issue 4

Madeleine L Cowie and Scott E Cowie*

• Clinical Assistant Professor, Department of General Surgery, University of British Columbia, Canada

Received:July 5, 2021   Published:July 13, 2021

Corresponding author: Scott E Cowie, Clinical Assistant Professor, Department of General Surgery, University of British Columbia, Canada

DOI: 10.32474/SCSOAJ.2021.06.000241

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Abstract

Background: Anaplastic large cell lymphoma is a lymphoid neoplasm that develops from T cells or natural killer cells. It comprises approximately two percent of all Non-Hodgkin lymphomas and accounts for 16 percent of T cell lymphomas. Anaplastic large cell lymphoma can occur as a primary systemic variant, which presents as an extracutaneous disease. Common extranodal sites of involvement are bone, stomach, lung, liver, and skin. However, little is known regarding cardiovascular involvement of systemic anaplastic large cell lymphoma. As this case depicts, it is vital for surgeons to be aware of the complex properties of anaplastic large cell lymphoma involving multiple organs, as a lack of knowledge can impede a proper diagnosis.

Case: We present a case of a 61-year-old male admitted with a diagnosis of acute appendicitis confirmed on CT. The patient presented with a 3-day history of fever, chills, severe abdominal pain and nausea. The patient was noted to have a non-tender, palpable mass in the right sartorius muscle. An MRI of this lesion suggested it to be a sarcoma. Despite antibiotic therapy, the patient become progressively septic and developed respiratory failure along with severe thrombocytopenia. Despite ventilator support, the patient passed away after several minutes of CPR. The cause of death was attributed to a fatal cardiac arrhythmia due to primary systemic anaplastic large cell lymphoma involving the heart, lungs, spleen, liver, and right sartorius muscle. The patient was also diagnosed with early acute appendicitis without perforation.

Conclusion: Our patient was in Stage IV anaplastic large cell lymphoma, as he had non-contiguous extralymphatic involvement. Due to the rarity of cardiovascular involvement of systemic anaplastic large cell lymphoma, there is limited data regarding the management and treatment. However, early detection of cardiac infiltration with appropriate diagnostic methods is crucial for a favourable outcome

Keywords: Appendicitis; Anaplastic Large Cell Lymphoma; Cardiac Involvement

Abbreviations: NK: Natural Killer Cells; ALCL: Anaplastic Large Cell Lymphoma; ALK: Anaplastic Lymphoma Kinase IPI: International Prognostic Index OS: Overall Survival; PFS: Progression-free survival

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