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Enhancing Diagnostic Precision: Intracardiac Echocardiography-Guided Endomyocardial Biopsy for Complex Right Atrial Mass.

JACC Case Rep

December 2024

Department of Cardiology, Centro Hospitalar Universitário Lisboa Norte,Centro Cardiovascular da Universidade de Lisboa (CCUL@RISE), Faculdade de Medicina da Universidade de Lisboa, Centro Académico de Medicina de Lisboa, Lisbon, Portugal.

An 80-year-old woman with a history of B-cell non-Hodgkin lymphoma presented to the emergency department with exertional dyspnea and lower limb edema. A transthoracic echocardiogram revealed a large extracardiac mass invading the right atrium. A diagnostic transcatheter endomyocardial biopsy guided by intracardiac echocardiography was performed.

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CNS lymphoma is a rare form of non-Hodgkin lymphoma that primarily affects the brain, spinal cord, leptomeninges, or eyes, leading to severe neurological or ophthalmological complications. This case report details a 44-year-old male with human immunodeficiency virus and diffuse large B-cell lymphoma who experienced permanent vision loss due to optic perineuritis, a rare presenting symptom indicative of underlying CNS involvement. Despite previous remission, imaging revealed focal enhancements suggesting CNS lymphoma, highlighting diagnostic and management challenges in relapsed lymphoma, especially in immunocompromised patients.

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Background: Classic Hodgkin lymphoma (CHL) is an extremely common non-acquired immunodeficiency syndrome (AIDS) defining malignancy and its incidence is rising. CHL is usually present in the lymph node and extranodal involvement is rare. Primary CHL of the gastrointestinal (GI) tract is exceedingly rare.

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Prizloncabtagene autoleucel (prizlon-cel), a novel bispecific chimeric antigen receptor (CAR) T-cell, targets and eliminates CD19/CD20 positive tumor cells. This phase 1, open-label study investigated the safety and efficacy of prizlon-cel in patients with relapsed/refractory B-cell non-Hodgkin Lymphoma (r/r B-NHL). Patients with CD19 and/or CD20-positive r/r B-NHL received a 3-day lymphodepletion (cyclophosphamide: 300 mg/m2/d; fludarabine: 30 mg/m2/d) followed by an intravenous dose of prizlon-cel.

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Purpose: To highlight a case report of high-grade primary lacrimal sac Burkitt lymphoma in a young adult.

Observation: A 25-year-old gentleman was referred to the oculoplastic center for left eye medial canthal progressive swelling at the level below the medial canthal tendon for two months associated with tearing. He was initially treated for preseptal cellulitis but failed to respond to antibiotics.

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