Key result
Hemodynamic-guided DA-EPOCH-R chemotherapy rapidly resolves mixed constrictive and obstructive cardiogenic shock within 48 hours.
Why the study?
Burkitt's lymphoma presenting as a cardiac mass causing mixed constrictive and obstructive cardiogenic shock is extremely rare and challenging to diagnose and manage.
Case Report (n=1)
No
This case highlights the critical utility of multimodality imaging and invasive pulmonary artery catheter monitoring for the diagnosis and real-time management of a rare, life-threatening mixed constrictive/obstructive shock caused by Burkitt's lymphoma.
Supports PAC-guided chemo in rare lymphoma shock; hypothesis-generating, needs prospective validation.
Burkitt's lymphoma is a highly aggressive B-cell lymphoma that rarely presents as an intracardiac mass or extracardiac mass involving the pericardium. We report a case of extracardiac Burkitt's lymphoma in a previously healthy 59-year-old man who presented with mixed constrictive and obstructive cardiogenic shock. Diagnosis was facilitated through multimodality imaging, including transthoracic echocardiography, cardiac MRI, chest CT, and invasive hemodynamic assessment using pulmonary artery catheters. These tools were instrumental in characterizing the constrictive and obstructive components of the patient's shock. A pulmonary artery catheter was also employed for ongoing hemodynamic monitoring during treatment with chemotherapy and tumor debulking agents. Remarkably, the patient showed rapid clinical improvement within 48 hours of initiating therapy, as evidenced by the hemodynamic monitoring trends.
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Ranum et al. (2026) conducted a case report in Burkitt's lymphoma with mixed constrictive and obstructive cardiogenic shock (n=1). DA-EPOCH-R chemotherapy and pulmonary artery catheter monitoring was evaluated. Treatment with DA-EPOCH-R chemotherapy, guided by pulmonary artery catheter hemodynamic monitoring, led to rapid resolution of mixed constrictive and obstructive cardiogenic shock within 48 hours.
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