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Clinical case of a 44-year-old patient with newly diagnosed peripheral T-cell lymphoma unspecified (Lennert’s lymphoma) and Loeffler’s endocarditis

https://doi.org/10.17650/1818-8346-2023-18-1-39-47

Abstract

Peripheral T-cell lymphoma unspecified (PTCLu) in most cases has an aggressive clinical course and is characterized by a high frequency of extranodal lesions. One of the manifestations of PTCLu, in particular Lennert’s lymphoma, is eosinophilia. Regardless of the development mechanism, eosinophilia can be accompanied by heart damage, leading to endomyocardial fibrosis, ventricular thrombosis and, in the final stage, to restrictive cardiomyopathies, which are manifestations of Loeffler’s endocarditis (LE). The presence of LE aggravates the course and prognosis of PTCLu, primarily limiting the possibilities of antitumor drug therapy. A multidisciplinary approach to managing a patient with PTCLu and concomitant LE makes it possible to diagnose and start both specific and cardiotropic therapy in a timely manner, ultimately improving the prognosis. A clinical case of a 44‑year-old patient with newly diagnosed PTCLu (Lennert’s lymphoma) and LE is presented.

About the Authors

Yu. E. Ryabukhina
Clinical Hospital “Lapino” of the “Mother and Child” Group of companies
Russian Federation

Yuliya Evgen’evna Ryabukhina

143081, Moscow region, Lapino, 1st Uspenskoe Shosse, 111



O. L. Timofeeva
Clinical Hospital “Lapino” of the “Mother and Child” Group of companies
Russian Federation

143081, Moscow region, Lapino, 1st Uspenskoe Shosse, 111



A. A. Akhobekov
Clinical Hospital “Lapino” of the “Mother and Child” Group of companies
Russian Federation

143081, Moscow region, Lapino, 1st Uspenskoe Shosse, 111



P. A. Zeynalova
Clinical Hospital “Lapino” of the “Mother and Child” Group of companies; I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)
Russian Federation

143081, Moscow region, Lapino, 1st Uspenskoe Shosse, 111
119991, Moscow, Trubetskaya St., 8, Build. 2



F. M. Abbasbeyli
Clinical Hospital “Lapino” of the “Mother and Child” Group of companies
Russian Federation

143081, Moscow region, Lapino, 1st Uspenskoe Shosse, 111



G. F. Allakhverdieva
Clinical Hospital “Lapino” of the “Mother and Child” Group of companies
Russian Federation

143081, Moscow region, Lapino, 1st Uspenskoe Shosse, 111



A. G. Zhukov
Clinical Hospital “Lapino” of the “Mother and Child” Group of companies
Russian Federation

143081, Moscow region, Lapino, 1st Uspenskoe Shosse, 111



V. V. Fedotov
Clinical Hospital “Lapino” of the “Mother and Child” Group of companies; UNIM LLC
Russian Federation

143081, Moscow region, Lapino, 1st Uspenskoe Shosse, 111
121205, Moscow, Skolkovo Innovation Center, Bolshoy Bulvar, 42c1 office 0.049 first core



L. A. Shestakova
Clinical Hospital “Lapino” of the “Mother and Child” Group of companies
Russian Federation

143081, Moscow region, Lapino, 1st Uspenskoe Shosse, 111



References

1. Swerdlow S.H., Campo E., Harris N.L. et al. WHO Classification of Tumors of Hematopoietic and Lymphoid Tissues. V. 2. Lyon: IARC, 2008. 439 p.

2. Weisenburger D.D., Savage K.J., Harris N.L. et al. Peripheral T-cell lymphoma, not otherwise specified: a report of 340 cases from the International Peripheral T-cell Lymphoma Project. Blood 2011;117(12):3402–8. DOI:10.1182/blood-2010-09-310342

3. Gallamini A., Stelitano C., Calvi R. et al. Peripheral T-cell lymphoma unspecified (PTCL-U): a new prognostic model from a retrospective multicentric clinical study. Blood 2004;103(7): 2474–9. DOI:10.1182/blood-2003-09-3080

4. Patsouris E., Engelhard M., Zwingers T., Lennert K. Lymphoepithelioid cell lymphoma (Lennert’s lymphoma): clinical features derived from analysis of 108 cases. Br J Haematol 1993;84(2):346–8. DOI:10.1111/j.1365-2141.1993.tb03079.x

5. Genereau T. Hypereosinophilic reactions in cancer. Rev Prat 2000;50(6):612–5.

6. Dombret H. Chronic hypereosinophilia and hematologic malignancies. Rev Prat 2000;50(6):627–9.

7. Ackerman S.J., Bochner B.S. Mechanisms of eosinophilia in the pathogenesis of hypereosinophilic disorders. Immunol Allergy Clin North Am 2007;27(3):357–75. DOI:10.1016/j.iac.2007.07.004

8. Klion A.D., Noel P., Akin C. et al. Elevated serum tryptase levels identify a subset of patients with a myeloproliferative variant of idiopathic hypereosinophilic syndrome associated with tissue fibrosis, poor prognosis, and imatinib responsiveness. Blood 2003;101(12):4660–6. DOI:10.1182/blood-2003-01-0006

9. Tai P.C., Ackerman S.J., Spry C.J. et al. Deposits of eosinophil granule protein in cardiac tissues of patients with eosinophilic endomyocardial disease. Lancet 1987;1(8534):643–7. DOI:10.1016/s0140-6736(87)90412-0

10. Slungaard A., Vercellotti G.M., Tran T. et al. Eosinophilic cationic granule proteins impair thrombomodulin function. A potential mechanism for thromboembolism in hypereosinophilic heart disease. J Clin Invest 1993;91(4):1721–30. DOI:10.1172/JCI116382

11. Gao M., Zhang W., Zhao W. et al. Loeffler endocarditis as a rare cause of heart failure with preserved ejection fraction: a case report and review of literature. Medicine (Baltimore) 2018;97(11):e 0079. DOI:10.1097/MD.0000000000010079

12. Doyen D., Buscot M., Eker A., Dellamonica J. Endomyocardial fibrosis complicating primary hypereosinophilic syndrome. Intensive Care Med 2018;44(12):2294–5. DOI:10.1007/s00134-018-5300-z

13. Hayashi S., Isobe M., Okubo Y. et al. Improvement of eosinophilic heart disease after steroid therapy: successful demonstration by endomyocardial biopsied specimens. Heart Vessels 1999;14(2): 104–8. DOI:10.1007/BF02481750

14. D’Amore F., Gaulard P., Trümper L. et al. Peripheral T-cell lymphomas: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 2015;26(suppl 5):v108–15. DOI:10.1093/annonc/mdv201

15. Nodal T-cell lymphomas. Russian clinical guidelines for the diagnosis and treatment of lymphoproliferative diseases. Eds.: I.V. Poddybnaya, V.G. Savchenko. Moscow, 2018. Pp. 98–105. (In Russ.).

16. Lee Y., Uhm J.E., Lee H.Y. et al. Clinical features and prognostic factors of patients with “peripheral T-cell lymphoma, unspecified”. Ann Hematol 2009;88(2):111–9. DOI:10.1007/s00277008-0544-2

17. Kojima H., Hasegawa Y., Suzukawa K. et al. Clinicopathological features and prognostic factors of Japanese patients with “peripheral T-cell lymphoma, unspecified” diagnosed according to the WHO classification. Leuk Res 2004;28(12):1287–92. DOI:10.1016/j.leukres.2004.04.016

18. Savage K.J., Chhanabhai M., Gascoyne R.D., Connors J.M. Characterization of peripheral T-cell lymphomas in a single North American institution by the WHO classification. Ann Oncol 2004;15(10):1467–75. DOI:10.1093/annonc/mdh392

19. NCCN Guidelines. Version 2.2022. Peripheral T-Cell Lymphomas.

20. Skryabina E.N., Safonova V.N., Agareva T.A. A rare case of Loeffler endocarditis associated with eosinophilic granulomatosis with polyangiitis. Saratovskiy nauchno-meditsinskiy zhurnal = Saratov Scientific Medical Journal 2017;13(4):823–8. (In Russ.).

21. Alam A., Thampi S., Saba S.G., Jermyn R. Loeffler endocarditis: a unique presentation of right-sided heart failure due to eosinophilinduced endomyocardial fibrosis. Clin Med Insights Case Rep 2017;10:1179547617723643. DOI:10.1177/1179547617723643

22. Allderdice C., Marcu C., Kabirdas D. Intracardiac thrombus in leukemia: role of cardiac magnetic resonance imaging in eosinophilic myocarditis. CASE (Phila) 2018;2(3):114–7. DOI:10.1016/j.case.2017.12.003


Review

For citations:


Ryabukhina Yu.E., Timofeeva O.L., Akhobekov A.A., Zeynalova P.A., Abbasbeyli F.M., Allakhverdieva G.F., Zhukov A.G., Fedotov V.V., Shestakova L.A. Clinical case of a 44-year-old patient with newly diagnosed peripheral T-cell lymphoma unspecified (Lennert’s lymphoma) and Loeffler’s endocarditis. Oncohematology. 2023;18(1):39-47. (In Russ.) https://doi.org/10.17650/1818-8346-2023-18-1-39-47

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ISSN 1818-8346 (Print)
ISSN 2413-4023 (Online)