Pericardial involvement at diagnosis in pediatric Hodgkin lymphoma patients

Hamid Bashir, Melissa M. Hudson, Sue C. Kaste, Scott Howard, Matthew Krasin, Monika L. Metzger

Research output: Contribution to journalReview article

16 Citations (Scopus)

Abstract

Background. Because most cases are clinically silent, the incidence, clinical course, and outcome of pericardial involvement in Hodgkin lymphoma are unknown. Methods. Records of all patients with newly diagnosed Hodgkin lymphoma treated at our institution between 1991 and 2004 were reviewed. Pericardial involvement was identified by computerized tomography (CT) as focal thickening or nodularity present at the time of diagnosis, and by echocardiography as pericardial effusion. Outcomes measured were incidence of pericardial involvement, relapse-free survival, and overall survival. Results. Thirteen of 273 patients (5%) had pericardial involvement. All patients with pericardial involvement had nodular sclerosing tumors versus 183 of 260 patients without pericardial involvement (P = 0.02); 9 (67%) had a bulky mediastinal mass versus 27% (P = 0.002). Two patients required pericardial drainage to drain very large effusions (n = 2). Both patients were symptomatic with either shortness of breath or superior vena cava syndrome. In the 11 cases that did not undergo surgical drainage, the effusion resolved within days after starting chemotherapy. Two patients experienced distant relapse but underwent successful salvage therapy. All 13 patients remain alive and free of disease at a median follow-up of 9.7 years (range, 1.7-12.9 years) with normal cardiac function. Conclusions. Pericardial involvement by lymphoma is usually asymptomatic unless accompanied by substantial pericardial effusion. In most cases, pericardial involvement resolves with treatment of the underlying malignancy, but close observation for hemodynamic complications is required. A symptomatic effusion, once treated, does not affect survival.

Original languageEnglish (US)
Pages (from-to)666-671
Number of pages6
JournalPediatric Blood and Cancer
Volume49
Issue number5
DOIs
StatePublished - Oct 15 2007

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Hodgkin Disease
Pediatrics
Pericardial Effusion
Survival
Drainage
Superior Vena Cava Syndrome
Recurrence
Salvage Therapy
Incidence
Dyspnea
Echocardiography
Lymphoma
Neoplasms
Hemodynamics
Tomography
Observation
Drug Therapy

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health
  • Hematology
  • Oncology

Cite this

Bashir, H., Hudson, M. M., Kaste, S. C., Howard, S., Krasin, M., & Metzger, M. L. (2007). Pericardial involvement at diagnosis in pediatric Hodgkin lymphoma patients. Pediatric Blood and Cancer, 49(5), 666-671. https://doi.org/10.1002/pbc.20993

Pericardial involvement at diagnosis in pediatric Hodgkin lymphoma patients. / Bashir, Hamid; Hudson, Melissa M.; Kaste, Sue C.; Howard, Scott; Krasin, Matthew; Metzger, Monika L.

In: Pediatric Blood and Cancer, Vol. 49, No. 5, 15.10.2007, p. 666-671.

Research output: Contribution to journalReview article

Bashir, H, Hudson, MM, Kaste, SC, Howard, S, Krasin, M & Metzger, ML 2007, 'Pericardial involvement at diagnosis in pediatric Hodgkin lymphoma patients', Pediatric Blood and Cancer, vol. 49, no. 5, pp. 666-671. https://doi.org/10.1002/pbc.20993
Bashir, Hamid ; Hudson, Melissa M. ; Kaste, Sue C. ; Howard, Scott ; Krasin, Matthew ; Metzger, Monika L. / Pericardial involvement at diagnosis in pediatric Hodgkin lymphoma patients. In: Pediatric Blood and Cancer. 2007 ; Vol. 49, No. 5. pp. 666-671.
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AU - Bashir, Hamid

AU - Hudson, Melissa M.

AU - Kaste, Sue C.

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AU - Krasin, Matthew

AU - Metzger, Monika L.

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N2 - Background. Because most cases are clinically silent, the incidence, clinical course, and outcome of pericardial involvement in Hodgkin lymphoma are unknown. Methods. Records of all patients with newly diagnosed Hodgkin lymphoma treated at our institution between 1991 and 2004 were reviewed. Pericardial involvement was identified by computerized tomography (CT) as focal thickening or nodularity present at the time of diagnosis, and by echocardiography as pericardial effusion. Outcomes measured were incidence of pericardial involvement, relapse-free survival, and overall survival. Results. Thirteen of 273 patients (5%) had pericardial involvement. All patients with pericardial involvement had nodular sclerosing tumors versus 183 of 260 patients without pericardial involvement (P = 0.02); 9 (67%) had a bulky mediastinal mass versus 27% (P = 0.002). Two patients required pericardial drainage to drain very large effusions (n = 2). Both patients were symptomatic with either shortness of breath or superior vena cava syndrome. In the 11 cases that did not undergo surgical drainage, the effusion resolved within days after starting chemotherapy. Two patients experienced distant relapse but underwent successful salvage therapy. All 13 patients remain alive and free of disease at a median follow-up of 9.7 years (range, 1.7-12.9 years) with normal cardiac function. Conclusions. Pericardial involvement by lymphoma is usually asymptomatic unless accompanied by substantial pericardial effusion. In most cases, pericardial involvement resolves with treatment of the underlying malignancy, but close observation for hemodynamic complications is required. A symptomatic effusion, once treated, does not affect survival.

AB - Background. Because most cases are clinically silent, the incidence, clinical course, and outcome of pericardial involvement in Hodgkin lymphoma are unknown. Methods. Records of all patients with newly diagnosed Hodgkin lymphoma treated at our institution between 1991 and 2004 were reviewed. Pericardial involvement was identified by computerized tomography (CT) as focal thickening or nodularity present at the time of diagnosis, and by echocardiography as pericardial effusion. Outcomes measured were incidence of pericardial involvement, relapse-free survival, and overall survival. Results. Thirteen of 273 patients (5%) had pericardial involvement. All patients with pericardial involvement had nodular sclerosing tumors versus 183 of 260 patients without pericardial involvement (P = 0.02); 9 (67%) had a bulky mediastinal mass versus 27% (P = 0.002). Two patients required pericardial drainage to drain very large effusions (n = 2). Both patients were symptomatic with either shortness of breath or superior vena cava syndrome. In the 11 cases that did not undergo surgical drainage, the effusion resolved within days after starting chemotherapy. Two patients experienced distant relapse but underwent successful salvage therapy. All 13 patients remain alive and free of disease at a median follow-up of 9.7 years (range, 1.7-12.9 years) with normal cardiac function. Conclusions. Pericardial involvement by lymphoma is usually asymptomatic unless accompanied by substantial pericardial effusion. In most cases, pericardial involvement resolves with treatment of the underlying malignancy, but close observation for hemodynamic complications is required. A symptomatic effusion, once treated, does not affect survival.

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