Primary Cardiac Lymphoma: Diagnosis by Transvenous Biopsy Under Transesophageal Echocardiographic Guidance

Unger, Philippe; Kentos, Alain; Cogan, Elie; Renard, Marc; Crasset, Vincent; Stoupel, Eric

doi:10.1016/s0894-7317(98)70129-4

Cited by 28 publications

(16 citation statements)

References 4 publications

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“…Three cases were diagnosed by means of endomyocardic biopsy [10,25,26]. Transvenous biopsies under simultaneous fluoroscopic and echocardiographic guidance represent a minimally invasive procedure including leftside samples [8] and provided diagnosis in five patients [8,12,18,20,41]. Pericardial biopsy was performed in four reviewed cases, with a 50% success rate [17,30].…”

Section: Discussionmentioning

confidence: 99%

“…In the reviewed cases, ten patients underwent surgery with no evidence of improvement in survival [3,6,9,15,19,23,27,35,38,39]. Prompt anthracycline-based chemotherapy has been administrated in 51% of the reviewed cases [1,3,6,7,8,9,12,17,19,20,25,26,29,30,31,38,39,41], resulting in 61% of complete remission (mean follow-up times 17 months; range 3-40 months). Radiotherapy was delivered to 17% of patients, alone or combined with chemotherapy, with a further improvement in survival [3,17,25,26,34,38].…”

Section: Discussionmentioning

confidence: 99%

“…It is an extranodal lymphoma involving only the heart and/or the pericardium [5]. We report 3 cases of primary cardiac lymphoma and review 35 cases from the literature [1,2,3,6,7,8,9,10,11,12,15,17,18,19,20,21,22,23,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,41].…”

Section: Introductionmentioning

confidence: 99%

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Primary cardiac lymphoma in immunocompetent patients: a report of three cases and review of the literature

et al. 2002

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Primary cardiac lymphoma is an extranodal non-Hodgkin's lymphoma exclusively located in the heart and/or pericardium, extremely rare in immunocompetent patients, and more frequent in immunodepressed patients. We present 3 retrospectives cases of primary cardiac lymphoma in immunocompetent patients and review 35 cases reported in the literature. Two patients were adults and one was a child. Primary cardiac lymphoma presented with constitutional symptoms in two cases and superior vena caval syndrome in one case. Diagnosis of a tumor mass was made in all cases by transthoracic echocardiography. Primary cardiac lymphoma arose in the heart right chambers in two cases. Histological diagnoses, obtained after thoracotomy, were diffuse large B-cell lymphoma in two cases, and Burkitt's lymphoma in one case. All three cases received chemotherapy, combined with radiotherapy in one patient. Of our patients, 2 are alive and asymptomatic 12 months and 33 months after diagnosis. In conclusion, diagnosis of primary cardiac lymphoma is difficult due to non-specific clinical manifestations and should be considered in patients with a cardiac mass sometimes with pericardial effusion. It is confirmed using transthoracic echocardiography and magnetic resonance imaging and certified using cytology or open biopsy. The only effective treatment is chemotherapy, but prognosis remains poor.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Primary cardiac lymphoma in immunocompetent patients: a report of three cases and review of the literature

et al. 2002

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“…There is an increased prevalence of primary cardiac lymphoma in immunocompromised patients, who are more prone to develop all forms of extranodal non-Hodgkin lymphoma (97). The diagnosis can be made from analysis of pericardial fluid (90,92,98), although direct biopsy is often necessary (89). Although primary cardiac lymphoma is rare, it is important to maintain a clinical suspicion for the tumor because early treatment with chemotherapy appears to be effective (83,89,99).…”

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CT and MR Imaging of Primary Cardiac Malignancies

Araoz¹,

Eklund²,

Welch³

et al. 1999

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Primary cardiac malignancies are rare tumors that are difficult to diagnose clinically. Different primary cardiac malignancies may have different clinical, morphologic, and radiologic features and intracardiac locations. Angiosarcoma is the most common primary cardiac malignancy. It tends to occur in the right atrium and involve the pericardium. Because of its tendency to hemorrhage, angiosarcoma often demonstrates areas of increased signal intensity with T1-weighted sequences. Undifferentiated sarcomas typically occur in the left atrium and have variable epidemiologic and radiologic features. Rhabdomyosarcoma is the most common primary cardiac malignancy in children and is more likely than other primary cardiac sarcomas to involve the valves. Primary cardiac osteogenic sarcoma almost always occurs in the left atrium and frequently demonstrates calcification. Certain features (eg, broad base of attachment, origin at a site other than the atrial septum) help differentiate this tumor from left atrial myxoma. Leiomyosarcoma favors the left atrium and tends to invade the pulmonary veins and mitral valve. Fibrosarcoma also tends to occur in the left atrium and is often necrotic. Liposarcoma is very rare and usually manifests as a large, infiltrating mass. Foci of macroscopic fat are occasionally seen. Primary cardiac lymphoma occurs more commonly in immunocompromised patients, frequently involves the pericardium, and, unlike other primary cardiac malignancies, may respond to chemotherapy. The advent of cross-sectional imaging has allowed earlier detection of primary cardiac malignancies as well as more accurate diagnosis and characterization.

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“…Previous reports demonstrate that a transvenous EMB procedure under fluoroscopic guidance is safe when performed by experienced technicians, the overall rate of complications is between 1% and 3%, the risk of cardiac perforation with tapenade is less than 0.05% (12,13). A transvenous EMB procedure under TEE guidance is a useful, simple and safe method (14)(15)(16)(17)(18)(19). However, it causes patient discomfort and sometimes requires general anesthesia in addition to local pharyngeal anesthesia.…”

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confidence: 99%

Diffuse Large B-cell Lymphoma Diagnosed by Intracardiac Echocardiography-guided Cardiac Tumor Biopsy

et al. 2012

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A 44-year-old man presented with exertional dyspnea. Transthoracic echocardiography (TTE) revealed a large tumor protruding into the right atrium and extending into the left ventricle. Cardiac magnetic resonance imaging and contrast enhanced computed tomography also confirmed the intracardiac tumor detected by TTE. An endomyocardial biopsy was performed under the intracardiac echocardiography (ICE) guidance, and he was diagnosed to have diffuse large B-cell lymphoma following the histological analysis. ICE-guided cardiac tumor biopsy is expected to be a useful diagnostic strategy that can minimize the risk of procedural complications.

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Primary Cardiac Lymphoma: Diagnosis by Transvenous Biopsy Under Transesophageal Echocardiographic Guidance

Cited by 28 publications

References 4 publications

Primary cardiac lymphoma in immunocompetent patients: a report of three cases and review of the literature

Primary cardiac lymphoma in immunocompetent patients: a report of three cases and review of the literature

CT and MR Imaging of Primary Cardiac Malignancies

Diffuse Large B-cell Lymphoma Diagnosed by Intracardiac Echocardiography-guided Cardiac Tumor Biopsy

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