scholarly journals Malignant pericardial effusion complicated by cardiac tamponade under atezolizumab

2021 ◽  
Vol 9 ◽  
pp. 2050313X2110360
Author(s):  
Lardinois Benjamin ◽  
Goeminne Jean-Charles ◽  
Miller Laurence ◽  
Randazzo Adrien ◽  
Laurent Terry ◽  
...  

Immune-related adverse events including cardiac toxicity are increasingly described in patients receiving immune checkpoint inhibitors. We described a malignant pericardial effusion complicated by a cardiac tamponade in an advanced non-small cell lung cancer patient who had received five infusions of atezolizumab, a PDL-1 monoclonal antibody, in combination with cabozantinib. The definitive diagnosis was quickly made by cytology examination showing typical cell abnormalities and high fluorescence cell information provided by the hematology analyzer. The administration of atezolizumab and cabozantinib was temporarily discontinued due to cardiogenic hepatic failure following cardiac tamponade. After the re-initiation of the treatment, pericardial effusion relapsed. In this patient, the analysis of the pericardial fluid led to the final diagnosis of pericardial tumor progression. This was afterwards confirmed by the finding of proliferating intrapericardial tissue by computed tomography scan and ultrasound. This report emphasizes the value of cytology analysis performed in a hematology laboratory as an accurate and immediate tool for malignancy detection in pericardial effusions.

1984 ◽  
Vol 2 (6) ◽  
pp. 631-636 ◽  
Author(s):  
S Davis ◽  
P Rambotti ◽  
F Grignani

Thirty-three unselected patients with cardiac tamponade secondary to malignant pericardial effusion were treated by intrapericardial instillation of tetracycline hydrochloride. Complete control of the initial signs and symptoms of tamponade was obtained in 30 patients without concomitant chemotherapy or radiotherapy. The procedure did not result in clinically significant complications. Failure of the technique was related to premature removal of the catheter by the patient (one patient) or the inability to totally remove hemorrhagic, clot-filled pericardial fluid (two patients). Survival ranged between 28-704 days and extended survival was related to the performance status and/or chemoradiosensitivity of the primary cancer. No patient successfully treated subsequently developed recurrent cardiac tamponade or alternatively, constrictive pericarditis. Tetracycline pericardial instillation remains a safe, simple, and efficacious treatment of tamponade secondary to malignant disease.


2016 ◽  
Vol 9 (1) ◽  
pp. 53
Author(s):  
Sultan Mahmud ◽  
Omar Sadeque Khan ◽  
Md. Aftabuddin ◽  
Asit Baran Adhikary

We present a case of 35 years old women who presented to our institution with a history of bilateral infiltrating duct cell carcinoma of breast, chest pain with heaviness, severe respiratory distress and hypotension. Echocardiography revealed massive pericardial effusion with features of cardiac tamponade. The patient was treated with urgent pericardiocentesis followed by subxiphoid pericardial window drainage of 500ml of haemorrhagic pericardial fluid. Cytological examina­tion confirmed the previous suspicious of malignancy. The patient tolerated the procedure very well, immediate sympto­matic relief was observed.


1997 ◽  
Vol 5 (4) ◽  
pp. 244-246
Author(s):  
Raju S Iyer ◽  
Sanjeev Agarwal ◽  
Bharadwaja Vamaraju ◽  
Srinivasu Kola ◽  
Srinivas Bhavanarushi ◽  
...  

A 35-year-old male underwent emergency pericardiectomy for repeated tamponade. A computed tomography scan of the thorax showed a consolidated lung lesion with pleural effusion. Emergency aspiration removed hemorrhagic pericardial fluid and straw colored pleural effusion. Both fluids tested negative for malignant cells. He later underwent a pneumonectomy after a biopsy revealed carcinoma of the lung. The case is reported to illustrate this rare presentation of bronchoalveolar carcinoma.


CHEST Journal ◽  
1982 ◽  
Vol 82 (4) ◽  
pp. 501-503 ◽  
Author(s):  
Frank E. Johnson ◽  
Michael K. Wolverson ◽  
Murali Sundaram ◽  
Elisabeth Heiberg

2021 ◽  
Vol 14 (3) ◽  
pp. e239772
Author(s):  
Elisabeth Martinez Fonseca ◽  
Igor Schonhofen ◽  
Maria Pereira Toralles ◽  
Jozelio Freire de Carvalho

A 23-year-old woman was diagnosed with Graves’ disease 5 months ago with decompensated thyroid function, for which she is taking thiamazole and propranolol. She developed progressive respiratory dyspnoea [New York Heart Association (NYHA) class III] and frequent palpitations. On emergency admission, the patient was tachypnoeic, hypotensive (77/54 mm Hg) and tachycardic (120 beats per minute), with an oxygen saturation of 94%. She also presented with cold, swollen and shaky extremities, with extended capillary filling time, and a significant reduction in heart sounds. Echocardiogram showed massive pericardial effusion compatible with cardiac tamponade. Pericardiocentesis was performed, with a drainage of 1420 mL serosanguinolent fluid, with prompt haemodynamic recovery. Analysis of the pericardial fluid showed exudates. A diagnosis of pericardial effusion secondary to Graves’ disease was determined and corticotherapy, lithium carbonate, cholestyramine and phenobarbital were prescribed. An oral iodine-131 was performed and the patient showed reasonable control of the clinical manifestations of hyperthyroidism. After 3 months, the patient showed no symptoms of hyperthyroidism and a new echocardiogram revealed a significant reduction in pericardial effusion.


2001 ◽  
Vol 83 (1) ◽  
pp. 143-145 ◽  
Author(s):  
Pankaj Kheterpal ◽  
Manoj Singh ◽  
Abdul Mondul ◽  
Lekshmi Dharmarajan ◽  
Anita Soni

2010 ◽  
Vol 2010 ◽  
pp. 1-3 ◽  
Author(s):  
Ahmet Cumhur Dülger ◽  
Özgür Kemik ◽  
Aziz Sümer ◽  
Hüseyin Akdeniz ◽  
Mehmet Emin Küçükoğlu ◽  
...  

Syndrome of inappropriate secretion of antidiuretic hormone (SIADH) is an extremely rare complication of infectious diseases. A rare case of brucellosis complicated by syndrome of inappropriate secretion of antidiuretic hormone (SIADH) cholestasis and pericardial involvement is reported. A 27-year-old woman was admitted for fever, abdominal pain, and scleral icterus. Her medical history revealed no recent use of diuretic agents. In addition to cholestasis and elevated liver enzymes, euvolemic hyponatremia, hypouricemia, low plasma osmolality, and high urinary osmolality were also detected. Surrenal and thyroid tests were also within normal range. Echocardiography revealed minimal pericardial effusion with normal cardiac functions. The final diagnosis was SIADH due to Brucellosis. Hyponatremia, cholestasis, and pericardial disease were resolved with effective antibrucellar treatment with streptomycine and doxycycline. After completing treatment of brucellosis, there was not any more evidence of cholestasis and pericardial fluid.


2007 ◽  
Vol 117 (1) ◽  
pp. e53-e55 ◽  
Author(s):  
Seung Hwan Han ◽  
Kwang Kon Koh ◽  
Sang Jin Lee ◽  
Jong Gu Seo ◽  
Su Jin Choi ◽  
...  

2009 ◽  
Vol 280 (4) ◽  
pp. 675-678 ◽  
Author(s):  
Emily E. Petersen ◽  
Alireza A. Shamshirsaz ◽  
Theresa M. Brennan ◽  
Elaine M. Demetroulis ◽  
Michael J. Goodheart

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