Cardiac Involvement in Non-Hodgkin Lymphoma, an Incidental Large Atrial Mass: A Case Report

Aledavood, Seyed Amir; Torghabeh, Ali Emadi; Shandiz, Fateme Homaee; Memar, Bahram

doi:10.17795/ijcp-3913

Cited by 7 publications

(15 citation statements)

References 21 publications

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“…In contrast, cardiac metastases from any histologic tumor types are 20- to 40 times more common [2]. Although it has been reported that lymphomas have cardiac metastases in 8.7% to 27% of cases, a mediastinal DLBCL infiltrating the heart and presenting as a large intracardiac mass is extremely rare [1,3]. This presentation was seen in our patient.…”

Section: Introductionmentioning

confidence: 56%

“…Signs and symptoms may be non-specific and include dyspnea, arrhythmias, pericardial tamponade or effusion, left ventricle or right ventricle outflow tract obstruction, tumor embolization, and valvular heart disease [3]. Other findings may include superior vena cava syndrome, peripheral embolization, and an intracardiac thrombus [6].…”

Section: Discussionmentioning

confidence: 99%

“…Chest X-ray may demonstrate cardiomegaly and signs of heart failure, which are non-specific findings [7]. Subsequent CT and magnetic resonance imaging will help determine size, spread of tumor, mediastinal involvement, and blood flow obstruction [3]. A PET/CT is also completed for staging and prognostication.…”

Section: Discussionmentioning

confidence: 99%

“…In the past, thoracotomy was done for tissue biopsy however less invasive tests are now used. These include TEE with biopsy, percutaneous intracardiac biopsy with combined fluoroscopy, endomyocardial biopsy, and pericardial fluid testing [3]. Pericardial fluid cytological testing may be used if pericardial effusion is present [6].…”

Section: Discussionmentioning

confidence: 99%

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A Rare Case of Diffuse Large B Cell Lymphoma Presenting as a Cardiac Mass

et al. 2019

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Rare disease Background: Primary mediastinal diffuse large B cell lymphoma (DLBCL) presenting as a large intracardiac tumor is extremely rare and has not been significantly reported in the literature. Cardiac lymphoma consists of 2 subtypes: mediastinal DLBCL invading the heart and primary cardiac lymphoma. Both subtypes have a poor prognosis and are treated similarly. Mediastinal DLBCL is a life-threatening condition that, if diagnosed early, has a better survival rate. This is a rare case of a mediastinal DLBCL invading the right atrium as a large intracardiac mass, causing partial obstruction of the tricuspid valve without hemodynamic compromise. Case Report: A 57-year-old female presented with unintentional weight loss, fatigue, exertional dyspnea, and cough for 8 weeks. Transesophageal echocardiogram showed a mass (3.5×3.5 cm) in the posterior wall of the right atrium partially obstructing the tricuspid valve. Biopsy revealed DLBCL. Given new-onset lymphoma, a human immunodeficiency virus (HIV) test was done and came back positive. CD4 count was 100 cells/mm 3. Chemotherapy was initiated with rituximab, cyclophosphamide, epirubicin, vincristine, and prednisone (R-CHOP). Highly active anti-retroviral (HAART) therapy was started for HIV. After treatment with R-CHOP and HAART, the patient had complete resolution of the mass and symptoms on follow-up imaging and evaluation at 6 months. Conclusions: Mediastinal DLBCL invading the heart is a life-threatening form of non-Hodgkin's lymphoma (NHL) and early diagnosis and treatment is critical as prognosis is poor especially if diagnosed in later stages of the disease. Testing for HIV is important as 5% of HIV patients are susceptible to developing NHL.

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Section: Introductionmentioning

confidence: 56%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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A Rare Case of Diffuse Large B Cell Lymphoma Presenting as a Cardiac Mass

et al. 2019

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“…Secondary cardiac involvement of lymphoma is relatively common, reported in 8.7-25% of documented clinical cases of lymphoma ( 1 ). Nevertheless, manifestations of cardiac involvement of lymphoma are often subclinical, thus, cardiac involvement as an initial presentation of malignant lymphoma is rare ( 2 , 3 ).…”

Section: Introductionmentioning

confidence: 99%

Secondary Cardiac Lymphoma Presenting as Sick Sinus Syndrome and Atrial Fibrillation Which Required Leadless Pacemaker Implantation

et al. 2021

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Cardiac involvement of malignant lymphoma is relatively common, although such a phenomenon has subclinical manifestations that are difficult to detect. We herein describe a patient with atrial fibrillation and sick sinus syndrome as the main symptoms. Computed tomography showed a mass in the right atrium extending into the superior vena cava (SVC). We implanted the patient with a leadless pacemaker. Transvenous biopsy revealed a diffuse large B-cell lymphoma. The patient was treated successfully with chemotherapy including rituximab. This case suggested that cardiac lymphoma may cause sick sinus syndrome, and leadless pacemaker implantation is a safe treatment option in patients with partial SVC obstruction.

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Diffuse large B-cell lymphoma with uncommon cardiac invasion

Daralammouri

Hamayel

Ismail

et al. 2022

SAGE Open Medical Case Reports

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Diffuse large B-cell lymphoma is the most common histologic subtype of non-Hodgkin lymphoma. Secondary involvement of the heart is seen late in advanced cases, it is uncommon for diffuse large B-cell lymphoma to present as intracardiac mass. A 26-year-old female patient presented with progressive shortness of breath, facial swelling, and lower limb edema. Imaging investigations by echocardiography and computed tomography showed a large right atrial mass that was obstructing the tricuspid valve. Open biopsy was taken, histopathology showed diffuse large B-cell lymphoma. She received six cycles R-CHOP chemotherapy (rituximab, cyclophosphamide, epirubicin, vincristine, and prednisone) with complete resolution of the mass. Diffuse large B-cell lymphoma can present with atypical and uncommon sites such as the heart as the first presentation. Early diagnosis and appropriate management is crucial given the poor outcome with late presentation. A high index of suspicion and the proper investigations is recommended to allow for early intervention and favorable outcomes as what happened with the case under discussion.

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Cardiac Involvement in Non-Hodgkin Lymphoma, an Incidental Large Atrial Mass: A Case Report

Cited by 7 publications

References 21 publications

A Rare Case of Diffuse Large B Cell Lymphoma Presenting as a Cardiac Mass

A Rare Case of Diffuse Large B Cell Lymphoma Presenting as a Cardiac Mass

Secondary Cardiac Lymphoma Presenting as Sick Sinus Syndrome and Atrial Fibrillation Which Required Leadless Pacemaker Implantation

Diffuse large B-cell lymphoma with uncommon cardiac invasion

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