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- Brian Cowie.
- Department of Anesthesia, St. Vincent's Hospital, Melbourne, 45 Victoria Parade, Fitzroy 3065, Australia. Electronic address: brian.cowie@svhm.org.au.
- J Clin Anesth. 2014 Dec 1;26(8):688-92.
AbstractA 65 year old man presented with fever, pancytopenia, hypoxemia, and cardiovascular collapse requiring intensive care unit admission. Computed tomographic pulmonary angiogram showed a right-sided mediastinal mass adjacent to the right atrium. The patient had a video-assisted thoracoscopic surgical biopsy of the mass, with selective bronchial blockade to maximize oxygenation during lung isolation. Intraoperative transesophageal echocardiography showed an unexpected large atrial secundum defect with a right-to-left shunt and intracardiac mass. This shunt could be reversed with a norepinephrine infusion, resulting in improved oxygenation. Histopathology showed potentially curative diffuse large B cell lymphoma (DLBCL). Crown Copyright © 2014. Published by Elsevier Inc. All rights reserved.
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