Infiltrative cardiac lymphoma with tricuspid valve involveme
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Case Report:
A 46-year-old man was admitted with symptomatic decompensated heart failure. He complained of progressive bilateral pitting edema with dyspnea on exertion and reduced effort tolerance of 3 wk duration. However, he denied orthopnea and paroxysmal nocturnal dyspnea. He had anorexia and weight loss for the past 3 mo. He had a 5 year history of hypertension which was well-controlled with oral antihypertensives. He had multiple admissions for angina but the coronary angiogram showed no stenosis. His previous echocardiography examination was normal. He was not a smoker. There was no family history of hematogenous malignancy or exposure to radiation at a young age.

He was thin with obvious muscle wasting. His conjunctiva was pink and there was no jaundice. The jugular venous pressure was elevated and he had gross leg edema. There was multiple small shotty cervical lymphadenopathy as well as several others in the axillary and inguinal region. The apex beat was displaced but the heart sounds were normal. There was no sign of cardiac tamponade. The chest examination was insignificant. There was no hepatosplenomegaly and ascites.

The hemoglobin level was 125 g/L. The total white cell count was 8.7 × 109/L and the platelet count was 360 × 109/L. The liver function test was normal with serum albumin of 47.1 g/L and serum globulin of 35.7 g/L. Serum transaminases were normal. The renal profile was impaired with calculated GFR of 27.5 mL/min per 1.73 m2. Serum lactate dehydrogenase was 268 U/L. Other hematology parameters were within normal range....
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