Tham khảo luận văn - đề án 'báo cáo y học: "cardiac tamponade mimicking tuberculous pericarditis as the initial presentation of chronic lymphocytic leukemia in a 58-year-old woman: a case report"', luận văn - báo cáo phục vụ nhu cầu học tập, nghiên cứu và làm việc hiệu quả | Lin et al. Journal of Medical Case Reports 2010 4 246 http content 4 1 246 jAc JOURNALOF medical ÌỤr case REPORTS CASE REPORT Open Access Cardiac tamponade mimicking tuberculous pericarditis as the initial presentation of chronic lymphocytic leukemia in a 58-year-old woman a case report Elaine Lin1 Adrienne Boire2 Vagish Hemmige2 Aliya N Husain3 Matthew Sorrentino4 Sandeep Nathan4 Shahab A Akhter4 Jerome Dickstein3 Stephen L Archer4 Abstract Introduction Chronic lymphocytic leukemia is an indolent disease that often presents with complaints of lymphadenopathy or is detected as an incidental laboratory finding. It is rarely considered in the differential diagnosis of patients presenting with tamponade or a large bloody pericardial effusion. In patients without known cancer a large bloody pericardial effusion raises the possibility of tuberculosis particularly in patients from endemic areas. However the signs symptoms and laboratory findings of pericarditis related to chronic lymphocytic leukemia can mimic tuberculosis. Case Presentation We report the case of a 58-year-old African American-Nigerian woman with a history of travel to Nigeria and a positive tuberculin skin test who presented with cardiac tamponade. She had a mild fever lymphocytosis and a bloody pericardial effusion but cultures and stains were negative for acid-fast bacteria. Assessment of blood by flow cytometry and pericardial biopsy by immunohistochemistry revealed CD5 and CD20 lymphocytes in both tissues demonstrating this to be an unusual manifestation of early stage chronic lymphocytic leukemia. Conclusion Although most malignancies that involve the pericardium clinically manifest elsewhere before presenting with tamponade this case illustrates the potential for early stage chronic lymphocytic leukemia to present as a large pericardial effusion with tamponade. Moreover the presentation mimicked tuberculosis. This case also demonstrates that it is possible to treat .
