A case of complete atrioventricular block associated with primary cardiac lymphoma reversed without cardiac pacemaker implantation

Abstract

Primary cardiac lymphoma (PCL) is a rare malignant lymphoma that is characteristically confined to the heart and/or pericardium. Here, the case of a 70-year-old male patient with complete atrioventricular block (AVB) associated with PCL is presented. The patient had a 10-month history of palpitation and electrocardiogram (ECG) showed a complete AVB. Additionally, transthoracic echocardiography indicated pericardial effusion where atypical lymphoid cells were identified by pericardiocentesis. Subsequent mediastinal lymph node biopsy revealed non-germinal centre diffuse large B-cell lymphoma. Therefore, a diagnosis of PCL was confirmed. As the patient’s vital signs were stable, he was prescribed chemotherapy without pacemaker implantation. After chemotherapy, the patient achieved remission and dynamic ECG demonstrated no recurrence of AVB. The present case demonstrates that although PCL initially manifesting as complete AVB is rare, this possibility should not be ignored when a new AVB without definite aetiology is encountered. In addition, if the vital signs of the patient are stable, pacemaker implantation may be postponed until the treatment effect of chemotherapy has been assessed.

Case Report: A case of third-degree atrioventricular block associated with primary cardiac lymphoma

“…In this paper, we noted that the patient presented with dyspnea, edema, multiple serous effusions, hepatic and renal dysfunction, coagulation dysfunction, sinus rhythm, third-degree atrioventricular block, full-lead low voltage, QT interval prolongation, and a borderline escape rhythm. Numerous studies have reported cases of primary cardiac lymphoma accompanied by atrioventricular block (Table 1) (14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25). The age of patients included in these studies ranged from 36.0 to 80.0 years, with 58.3% of them being men.…”

A rare cause of dyspnea: Primary large B cell lymphoma causes giant cardiac mass

“…In patients with pericardial involvement, it may present with pericarditis, pericardial effusion or tamponade. Finally, the tumor affecting the conduction pathways can cause various heart blocks 4–6 …”

“…Left atrial tumors such as myxoma may mimic mitral stenosis and cause systemic embolism, while right atrium or right F I G U R E 1 CT shows giant mass filling the atrium and ventricle (Coronal and axial plane) F I G U R E 2 MRI demonstrates giant mass invading myocardium and pericardium (Coronal plane) F I G U R E 3 Mass excised from right atrium and ventricle ventricular tumors may cause pulmonary embolism and right heart failure.In patients with pericardial involvement, it may present with pericarditis, pericardial effusion or tamponade. Finally, the tumor affecting the conduction pathways can cause various heart blocks [4][5][6].…”