Cardiac lymphoma presenting as bradyarrhythmia

Sanders, Mason; Gazda, Casey; O’Quinn, Michael P.; Klein, J. Larry; Khalfan, Reza; Gehi, Anil K.

doi:10.1016/j.hrcr.2022.04.011

Cited by 4 publications

(1 citation statement)

References 15 publications

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“…Furthermore, atrioventricular (AV) node conduction abnormalities were usually amenable to chemotherapy. The addition of high-dose prednisone, however, was associated with the resolution of persistent heart block after chemotherapy [19].…”

Section: Resultsmentioning

confidence: 94%

Cardiac Metastasis in Diffuse Large B Cell Lymphoma: Article Review

2024

Cardiol Res Cardiovasc Med

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Diffuse Large B Cell Lymphoma (DLBCL) is the most common subtype of non-Hodgkin's lymphoma that metastasizes to the heart. It was considered rare and was detected mainly at autopsy, but the prevalence has risen in recent times. The prognosis is poor if left untreated. Although most cases respond to chemotherapy well, the treatment can be associated with life-threatening complications including ventricular fibrillation, pulmonary embolism, and cardiac rupture early after chemotherapy. Little data is available regarding the optimal approach. A reduced chemotherapy dose was reported in several cases to decrease the risk of complications however, the inadequate treatment of cancer remains a concern. Moreover, chimeric T-cell (CAR-T cell) therapy resulted in significant improvement in other cases. In this manuscript, we intend to explore the symptoms and treatment of DLBCL with cardiac metastasis and the resulting outcomes. Our study includes 29 published cases older than 18 years with DLBCL who were diagnosed with cardiac metastasis. In 50% of cases, cardiac metastasis was detected at the initial presentation and diagnosis of lymphoma. Shortness of breath was the most common manifestation. 80.7 % of the cases underwent isolated chemotherapy and signs of improvement were reported as early as 1 month. Reduced chemotherapy dose was performed just in one case for the first cycle. Five out of 29 patients expired despite treatment. Arrhythmia was the cause of death in one patient. CAR-T cell, which was performed in 3 cases with resistance to chemotherapy, was associated with favorable outcomes.

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Section: Resultsmentioning

confidence: 94%

Cardiac Metastasis in Diffuse Large B Cell Lymphoma: Article Review

2024

Cardiol Res Cardiovasc Med

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Primary cardiac lymphoma presenting with cardiac tamponade and complete heart block: case report

Kelleher,

Bird,

Hayes

et al. 2023

European Heart Journal - Case Reports

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Background Primary Cardiac Lymphoma (PCL) is rare and its presentation can be variable. Thorough workup of suspected PCL or other cardiac tumours typically incorporates a range of imaging techniques and laboratory investigations but ultimately diagnosis is confirmed by histological analysis of myocardial tissue. Case Summary An 80 year old Caucasian female presented with complete heart block and symptomatic cardiac tamponade. A pericardiocentesis was performed and a dual chamber permanent pacemaker was implanted for management of her complete heart block. Subsequently a right atrial mass was discovered on imaging and the patient underwent endomyocardial biopsy of the mass. Histological analysis of the sample confirmed a primary cardiac lymphoma. The patient opted to forgo treatment with chemotherapy and died from her disease one month later. Discussion Cardiac arrhythmias can occur in PCL due to infiltration of conduction pathways. Characterisation of cardiac masses on various imaging modalities and laboratory tests guides diagnosis. Tissue diagnosis is required to confirm PCL. The location of a cardiac mass may present technical challenges when undertaking biopsy, so the best approach to tissue sampling should be considered on an individual basis. Without treatment survival is less than one month but with modern chemoimmunotherapy 5-year survival may exceed 50%.

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Patient With a Diffuse Large B-Cell Non-Hodgkin Lymphoma in the Right Heart Chamber That Caused Cardiogenic Shock Was Well-Responded to Corticosteroids and Chemotherapy

Trung Nguyen,

Van Dang,

Thai Pham

et al. 2024

Clin Med Insights Case Rep

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Heart tumors are sporadic. Secondary heart tumors are 30 times more common than primary ones. Depending on the location and origin of the tumor, clinical pictures vary from asymptomatic to severe manifestations such as arrhythmia, heart failure, pericardial effusion, and cardiogenic shock. We report hereby a rare case who presented with faint clinical symptoms, rapidly progressing to right heart failure within a month. Echocardiography and computed tomography of the chest revealed a tumor in the right heart chamber of 72.0 × 43.0 mm, in addition to large mediastinal lymph and left supraclavicular lymph nodes, cardiogenic shock appeared 4 days after admission. Through examination, it was suspected that this was a cardiac lymphoma. The patient was treated with 2 mg methylprednisolone per kg body weight. Symptoms of cardiogenic shock improved significantly and disappeared after 6 hours of treatment. After supraclavicular lymph node biopsy and immunohistochemistry, the final result was diagnosed as diffuse large B-cell non-Hodgkin lymphoma with large lymphoma in the right heart. The patient received chemotherapy with the R-CHOP regimen (Rituximab, Cyclophosphamide, Doxorubicin, Vincristine, and Prednisolone). Re-examination before the 5th chemotherapy cycle showed no signs of right heart failure, normal self-activity, and no dyspnea on exertion, and the tumor size in the heart on the echocardiogram was 23.8 × 19.1 mm. The report shows that a large right heart tumor with a clinical picture of cardiogenic shock in a patient with diffuse large B-cell non-Hodgkin’s lymphoma was well-responded to initial treatment with methylprednisolone at a dose of 2 mg/kg body weight and R-CHOP chemotherapy.

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Cardiac lymphoma presenting as bradyarrhythmia

Cited by 4 publications

References 15 publications

Cardiac Metastasis in Diffuse Large B Cell Lymphoma: Article Review

Cardiac Metastasis in Diffuse Large B Cell Lymphoma: Article Review

Primary cardiac lymphoma presenting with cardiac tamponade and complete heart block: case report

Patient With a Diffuse Large B-Cell Non-Hodgkin Lymphoma in the Right Heart Chamber That Caused Cardiogenic Shock Was Well-Responded to Corticosteroids and Chemotherapy

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