From the Radiologic Pathology Archives: Cardiac Lymphoma: Radiologic-Pathologic Correlation

Abstract

Lymphoma of the heart and pericardium is usually present as one aspect of disseminated disease and rarely occurs as a primary malignancy. It accounts for 1.3% of primary cardiac tumors and 0.5% of extranodal lymphomas. Cardiac lymphomas are most commonly diffuse large cell lymphomas and frequently manifest as an ill-defined, infiltrative mass. Atrial location is typical; the right atrium is most often affected. Pericardial thickening or effusion is often a common early feature of disease. Infiltration of atrial or ventricular walls with extension along epicardial surfaces is also a notable feature. At computed tomography, the attenuation of cardiac lymphoma may be similar to or lower than that of normal myocardium. At magnetic resonance imaging, it has variable signal intensity and contrast enhancement. Clinical manifestations may include pericardial effusion, cardiac arrhythmias, and a variety of nonspecific electrocardiographic abnormalities, notably first- to third-degree atrioventricular block. Treatment most commonly includes anthracycline-based chemotherapy and anti-CD20 treatment. Chemotherapy has been used alone or combined with radiation therapy. Palliative surgery has been performed, mainly for tumor debulking. The prognosis for patients with either primary or secondary lymphomatous heart involvement is usually poor; late diagnosis is one of the major factors affecting outcome.

RETRACTED: An Uncommon Case of Secondary Cardiac Lymphoma Manifested through Pre-Syncope, Syncope Episodes and Atrial Flutter

“…Cardiac involvement due to metastasis of malignant tumors is relatively uncommon and is associated with poor prognosis. Autopsy studies have shown up to 10% -12% of cardiac involvement in all patients with malignancy [1]. The most frequent metastatic malignancies, in absolute terms, to the heart are lung and breast carcinomas, followed by lymphomas [2].…”

Fluorine-18-FDG PET/CT finding of cardiac lymphoma -a case report

“…Primary cardiac lymphoma rarely occurs and accounts for 1.3% of primary cardiac tumors and 0.5% of extranodal lymphomas, the right atrium is most common location, and diffuse large B-cell lymphomas (DLBCL) is usual form [1][2][3][4].…”

“…Actually, the diagnosis is often difficult, early diagnosis and treatment is a key to success for good outcome [1].…”

Typical and Atypical Magnetic Resonance Imaging Appearances of Primary Cardiac Lymphoma

“…It usually affects the right heart chamber [2,4]. Dyspnea is the most common symptom, followed by chest pain and constitutional symptoms.…”

“…Typically, it is isointense on T1 weighted, iso-to hyperintense on T2 weighted, and is not suppressed on fat suppression sequences. PCL demonstrates heterogeneous enhancement following gadolinium administration [3,4]. Encasement of the RCA, when present, favors PCL over angiosarcoma [5].…”