INCIDENTAL FINDING OF LYMPHOMA DURING INTERNAL THORACIC ARTERY HARVESTING FOR CORONARY ARTERY BYPASS SURGERY

Hakan GERÇEKOĞLU, Tufan ŞENER, Bige AYDIN, İlknur KIYGILl

Dr Siyami Ersek Cardiovascular and Thoracic Surgery Center, Haydarpaşa, Istanbul, Turkey

Internal thoracic artery (ITA) graft is used widely as a bypass conduit for its well known long term patency in coronary artery surgery. ITA is commonly harvested with its associated tissue, with the vena comitantes, lymphatic channels and lymph nodes. We present a case of lymphoma which came to medical attention by incidental finding of lymphadenopathies during internal thoracic artery harvesting. Lymphomas are malignant neoplasms of the immune system characterized by proliferation of lymphoid tissue cells which present mostly with persistent painless peripheral lympadenopathy. Lymphadenopathies on internal thoracic artery pedicle deserve further examination. The differential diagnosis includes infections and other neoplasms especially metastatic tumors. We suggest that use of the ITA as a bypass graft is still possible in spite of lymhadenopathies on its pedicle unless these impair its vascular integrity and flow.

Keywords : coronary artery by-pass surgery, internal thoracic artery, lymphadenopahty, lymphoma

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