An Assessment of Primary Cardiac Lymphoma: A Rare Case in Indonesia

Abstract

Introduction: : Primary cardiac lymphoma (PCL) is an uncommon malignancy with a high mortality rate. The disease is commonly found as non-Hodgkin’s lymphoma (NHL), mainly located in the heart or pericardium. PCL is difficult to diagnose due to its unspecific clinical manifestations. Echocardiography, computed tomography (CT) scanning, and magnetic resonance imaging (MRI) can help in diagnosing PCL, but histopathological examination is the gold standard for a definitive diagnosis. Therefore, this study aimed to compare the case of malignant cardiac lymphoma and MRI with earlier related literature. Case Presentation: This study reported a case of PCL in 52 years old male who came to Cipto Mangunkusumo Hospital with intra cardiac tumour and underwent surgery with median sternotomy. CT scan of the chest showed a mass in the left atrial and no significant abnormalities in other organs. Histopathological examination showed the morphologic feature of diffuse monotonous proliferation of atypical large B lymphocytes. The lymphoma diagnosis was supported by immunohistochemistry including CD20, MUM1, and Ki67 positivity. Conclusions: PCL was difficult to diagnose due to nonspecific clinical manifestations. Immunostaining helped to diagnose more specifically and determine the treatment plan. Histologic finding from PCL was mostly Diffuse Large B-cell lymphoma (DLBCL) and the prognosis was poor. Therefore, identifying the subtype of DLBCL was important for prognostic.