Emergency management of a 13-year-old patient with primary mediastinal B cell lymphoma: Extracorporeal membrane oxygenation and superior vena cava stent prior to chemotherapy

Abstract

Background: Primary mediastinal B cell lymphoma (PMBCL) is a rare type of non-Hodgkin's lymphoma, and prompt diagnosis and initiation of chemotherapy are necessary to limit compression of cardiovascular structures. Case report: A 13-year-old patient was diagnosed with PMBCL, resulting in acute hypoxemic respiratory failure and cardiogenic shock with clinical pericardial tamponade. Chemotherapy was initiated after veno-arterial extracorporeal membrane oxygenation and subsequent endovascular stenting of the superior vena cava (SVC) to optimize cardiac output due to malignant SVC syndrome. Conclusion: We discuss the challenges of diagnosis and emergency management of pediatric patients with PMBCL and review the existing relevant literature for SVC syndrome secondary to PMBCL.

Keywords

• Extracorporeal membrane oxygenation
• Mediastinal mass
• Superior vena cava syndrome
• Interventional cardiology