A Case of Neurally Mediated Syncope Caused by Cervical Malignant Lymphoma

We report herein on a case of a 74 year old male with neurally mediated syncope caused by cervical malignant lymphoma. He visited our hospital complaining of a rapidly-growing left cervical mass. Local findings showed an elastic soft mass with tenderness in his cervical region. We performed an open biopsy and pathological diagnosis was diffuse large B-cell lymphoma, so we planned to treat him with CHOP therapy. But before chemotherapy, loss of consciousness occurred. This syncope was considered to be neurally mediated syncope caused by the compression of the carotid sinus by the cervical malignant lymphoma. His cervical malignant lymphoma rapidly shrank after CHOP therapy, and general fatigue and bradycardia decreased day by day. If cardiac pacemaker insertion is not enforced for a case of neurally mediated syncope, the frequency of the syncope increases. In this case the cervical tumor was reduced by CHOP therapy and the syncope and bradycardia disappeared. The patient was able to avoid cardiac pacemaker insertion.