Left ventricular thrombus in a patient with cutaneous T-cell lymphoma, hypereosinophilia and Mycoplasma pneumoniae infection – a challenging diagnosis: a case report

Left ventricular thrombus in a patient with cutaneous T-cell lymphoma, hypereosinophilia and Mycoplasma pneumoniae infection – a challenging diagnosis: a case report

Journal of Cardiothoracic Surgery, February 2015

25889614

Claudia Oeser, Martin Andreas, Claus Rath, Andreas Habertheuer, Alfred Kocher

Differential diagnoses of cardiac masses include primary benign and malignant neoplasms, secondary neoplasms, and non-neoplastic masses, such as thrombi. Owing to different therapeutic approaches and the way these affect the prognosis, the early and correct diagnostic determination of the etiology of a cardiac mass is of utmost importance and essential for the appropriate management of patients.We report a case of a 52-year-old woman with a left ventricular mass in the setting of a recent Mycoplasma pneumoniae infection and a medical history of cutaneous T-cell lymphoma and hypereosinophilia. Imaging findings were consistent with both an infiltrative process of the lymphoma and a cardiac thrombus. An estimated very high risk for embolization led to the indication for open-heart surgery for the removal of the cardiac mass. Histopathological examination confirmed the presence of a thrombus; there were no signs of malignancy. The patient was discharged 11 days after surgery in good general condition and is now in outpatient care for follow-up and further management.This case highlights possible challenges in the diagnostic assessment of cardiac masses and their management in a patient with several underlying diseases and a complex medical history.