Primary Cardiac Lymphoma

Baztarrica, Gabriel Pérez; Nieva, Norma; Gariglio, Luis; Salvaggio, Flavio; Porcile, Rafael

doi:10.1161/circulationaha.109.863126

Cited by 26 publications

(7 citation statements)

References 7 publications

(12 reference statements)

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“…myxoma), but tumor embolism into the pulmonary circulation has been described as well (e.g. lymphoma) ( 6 , 7 ). Hemodynamically, tumors reduce cardiac output (stroke volume) y causing intra-cavity obstruction or valvular dysfunction.…”

Section: Introductionmentioning

confidence: 99%

Cardiac tumors: echo assessment

2016

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Cardiac tumors are exceedingly rare (0.001–0.03% in most autopsy series). They can be present anywhere within the heart and can be attached to any surface or be embedded in the myocardium or pericardial space. Signs and symptoms are nonspecific and highly variable related to the localization, size and composition of the cardiac mass. Echocardiography, typically performed for another indication, may be the first imaging modality alerting the clinician to the presence of a cardiac mass. Although echocardiography cannot give the histopathology, certain imaging features and adjunctive tools such as contrast imaging may aid in the differential diagnosis as do the adjunctive clinical data and the following principles: (1) thrombus or vegetations are the most likely etiology, (2) cardiac tumors are mostly secondary and (3) primary cardiac tumors are mostly benign. Although the finding of a cardiac mass on echocardiography may generate confusion, a stepwise approach may serve well practically. Herein, we will review such an approach and the role of echocardiography in the assessment of cardiac masses.

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Section: Introductionmentioning

confidence: 99%

Cardiac tumors: echo assessment

2016

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“…Therefore, we could not have predicted that she might be at risk for sudden death if we had not requested echocardiography be performed. Pérez et al reported a case in which the tumor developed on the right side of the heart, eventually progressing to tumoral pulmonary embolism, followed by death ( 8 ). It is thus clear that an early diagnosis is essential for preventing such complications.…”

Section: Discussionmentioning

confidence: 99%

Primary Cardiac Diffuse Large B-cell Lymphoma Promptly and Safely Diagnosed with Pericardial Effusion Cytology

et al. 2020

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Primary cardiac lymphoma is a rare condition with a poor prognosis, and patients are at risk for sudden cardiac death. A prompt diagnosis and early treatment are therefore essential. A 68-year-old woman was admitted for shortness of breath and peripheral edema. Echocardiograms showed massive pericardial effusion and a mass on the free wall of the right atrium and ventricle. Subsequent pericardial effusion cytology revealed diffuse large B-cell lymphoma. We started chemotherapy with rituximab and achieved a good clinical course. This case is made unique by the use of pericardial effusion cytology, which allowed us to diagnose primary cardiac lymphoma promptly and safely.

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“…RVOT obstruction can cause right-sided heart failure or hemodynamic instability ( 4 ), invasion of the conduction pathways can cause arrhythmias such as atrioventricular blocks ranging from first- to third-degree blocks, infiltration to the myocardium can cause VT and invasion of the pericardium can produce pericardial effusion and tamponade. Finally, tumor embolization ( 5 ) or mass encasing a coronary can cause ischemic symptoms ( 6 ).…”

Section: Discussionmentioning

confidence: 99%

A male with multiple cardiac masses

et al. 2018

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SummaryThirty-seven-year-old male presented with cough, dyspnea, significant weight loss (20 kg) and subacute fever for the past 2 months. Physical examination revealed inspiratory and expiratory wheezing bilaterally. A normal S1, S2 and a 3/6 systolic ejection murmur at the left upper parasternal border with respiratory variation were found during cardiac auscultation. Kidney and bone marrow biopsy reported a high-grade B-cell lymphoma. Echocardiography and cardiac CT findings consisted of multiple intracardiac masses affecting the right ventricular (RV) outflow track, RV apex, medial portion of the right atrium and posterior left atrium, as well as mild impairment of the RV systolic function. The masses in the RV outflow track caused partial obstruction (pulmonary valve peak velocity 2.3 m/s) with a RV systolic pressure of 43 mmHg. The infiltrative mass in the interatrial septum extended into both the right and left atrial cavities. The right superior pulmonary vein was occluded. This patient was treated with aggressive chemotherapy and had a good clinical response that resulted in mass size reduction after the first course of chemotherapy. Multimodality imaging techniques such as echocardiography, cardiac CT and PET scan can provide complementary information to better evaluate, stage and manage these patients.Learning points:Lymphoma can be found as a primary tumor in cardiac tissue, but secondary cardiac lymphoma is far more common.Appropriate investigation, histopathology, immunophenotype, staging and risk assessment are required for definite diagnosis and treatment.Cardiac lymphoma frequently manifests as an ill-defined, infiltrative mass. Typical location is in the atrium (right atrium is the most common site). Pericardial thickening or effusion is also common.Echocardiography is a quick, bedside, non-invasive assessment of anatomical involvement and hemodynamics affected by cardiac lymphoma. Echocardiographic findings of cardiac lymphoma include a hypoechoic, ill-defined infiltrative masses in the myocardium, nodular protrusion into cardiac chambers and pericardial effusion. Obstruction of inflow/outflow track can also be found.If a diagnosis of cardiac lymphoma is made, the most effective treatment is chemotherapy. Surgical treatment may have a role when hemodynamic compromise does not respond to chemotherapy and radiotherapy.

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Primary Cardiac Lymphoma

Cited by 26 publications

References 7 publications

Cardiac tumors: echo assessment

Cardiac tumors: echo assessment

Primary Cardiac Diffuse Large B-cell Lymphoma Promptly and Safely Diagnosed with Pericardial Effusion Cytology

A male with multiple cardiac masses

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