Linfoma Periaórtico Tóraco-abdominal, que simula un síndrome aórtico agudo, y revisión de la literatura

Resumen

We report the case of a 70-year-old woman in whom a systemic non-Hodgkin’s lymphoma was diagnosed late after she presented with the clinical features of an acute aortic syndrome. A CT scans showed the presence of a large thoracoabdominal periaortic soft tissue mass without aneurism or dissection. Later a biopsy of the mass was performed which showed a non-Hodgkin’s lymphoma. Chemotherapy with CHOP-R was effective, with complete initial resolution of the mass, developping in the follow up chylothorax, malnutrition and death. The systemic lymphoma that compromises the aorta it is called periaortic lymphoma, and may be misinterpreted clinically or in CT scan mimicking a thoracic aortic aneurysm, dissection, penetrating ulcer or an intramural haematoma. In some cases both situations may coexist, in others the lymphoma it is the underlying cause. To our knowledge, only 42 cases (including ours) of periaortic lymphoma have been reported in literature. Unusual morphology on CT scans and MR images, such as a skip area or unusual circumferential encasement of the aorta, as in this case, should suggest a neoplasm.