Primary Cardiac Lymphoma Mimicking Left Atrial Myxoma in an Immunocompetent Patient

Nguyen, Duyen Thuy; Meier, Carl Richard; Schneider, Dan

doi:10.1200/jco.2007.12.5955

Cited by 13 publications

(12 citation statements)

References 16 publications

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“…24 Exceptional cases can mimic cardiac myxoma clinically. 25,26 In case 3, the cardiac myxoma may have provided the 'soil' for the chronic inflammation, as cardiac myxoma can produce proinflammatory cytokines and be associated with systemic inflammatory symptoms. 27 Recently, Bagwan et al 28 reported two cases of incidental DLBCL, one in a valvular homograft and one in an atrial myxoma, quite similar to case 3.…”

Section: Discussionmentioning

confidence: 99%

Diffuse large B-cell lymphoma associated with chronic inflammation as an incidental finding and new clinical scenarios

et al. 2010

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Diffuse large B-cell lymphoma that develops in the setting of long-standing chronic inflammation is typically associated with Epstein-Barr virus, and usually presents as tumor mass involving body cavities, as in pyothorax-associated lymphoma. It is listed as a distinct entity in the latest World Health Organization lymphoma classification. We report four cases that were incidentally discovered on histologic examination, one each in a splenic false cyst, a long-standing hydrocele, an atrial myxoma, and metallic-implant wear debris. Microscopic foci of atypical (neoplastic) large lymphoid cells were found within the contents of the cysts or curettage material, or within the stroma of the atrial myxoma. Despite the diverse clinical scenarios, all cases showed a homogeneous phenotype: positivity for B-lineage markers (CD20 þ , CD79a þ , PAX5 þ ), non-germinal center immunophenotype (CD10À, BCL6À/ þ , MUM-1 þ ), and positivity for Epstein-Barr virus with type III latency (LMP1 þ , EBNA2 þ ). The last feature supports the hypothesis that the lymphoma has arisen in a setting of 'local immunodeficiency' as a result of long-standing chronic inflammation in an enclosed space, a characteristic pathogenetic mechanism of diffuse large B-cell lymphoma associated with chronic inflammation. These cases therefore expand the spectrum of this entity to include new clinical scenarios for the development of this lymphoma type.

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Section: Discussionmentioning

confidence: 99%

Diffuse large B-cell lymphoma associated with chronic inflammation as an incidental finding and new clinical scenarios

et al. 2010

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“…3 Cardiac myxoma, usually involving the left atrium, is another possible diagnosis. 2,4 The differentiation is frequently challenging. 3 A normal cardiac history and normal ECG findings may help in distinguishing an intracardiac tumor from a mural thrombus.…”

Section: Discussionmentioning

confidence: 99%

Mediastinal diffuse large B-cell lymphoma invading the left atrium mimicking coronary artery disease with a mural thrombus

Yang

Tsai

Lai

et al. 2012

Journal of the Chinese Medical Association

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A left atrial mass associated with coronary artery disease is often diagnosed as a mural thrombus rather than other possible etiologies such as benign primary cardiac tumor (myxoma, lipoma), a malignant primary cardiac tumor (sarcoma, lymphoma), or secondary involvement for extracardiac tumors. Malignant lymphoma initially presenting as intracardiac masses is very rare. Chest computed tomography with contrast enhancement and cardiac magnetic resonance may be the best methods for distinguishing primary cardiac tumors from direct extension from adjacent mediastinal structures. We report the case of a 59-year-old man with incidentally found mediastinal diffuse large B-cell lymphoma invading the left atrium, which presented with coronary artery disease and a left atrial mass. Improvement in cardiac ventricular function heart after coronary artery bypass grafting may provide the patient with a better chance of receiving an adequate dose of chemotherapy.

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“…This makes the differential diagnosis of myxomas or atrial thrombus important. Myxomas often involve the left atrium and might protrude into the left ventricle 7. Atrial thrombus is often found in the left atrial appendage under the condition of rheumatic mitral stenosis or atrial fibrillation.…”

Section: Discussionmentioning

confidence: 99%

Cardiac lymphoma with first manifestation of recurrent syncope-a case report and literature review

Lin¹

2010

IMCRJ

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Cardiac involvement, as an initial presentation of malignant lymphoma is rare. We report a 42-year-old Taiwanese man with frequent syncope. Routine electrocardiography disclosed complete atrioventricular block. Before permanent pacemaker implantation was undertaken, transthoracic echocardiography revealed a solid mass infiltrating the left atrium and interatrial septum. Transesophageal echocardiography proved cardiac neoplasm with biatrial infiltration. Endomyocardial tissue biopsy was performed under angiography guide. Pathology diagnosis unraveled large B-cell lymphoma. Despite aggressive chemotherapy, the patient's condition worsened and he died 2 months later.

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Primary Cardiac Lymphoma Mimicking Left Atrial Myxoma in an Immunocompetent Patient

Cited by 13 publications

References 16 publications

Diffuse large B-cell lymphoma associated with chronic inflammation as an incidental finding and new clinical scenarios

Diffuse large B-cell lymphoma associated with chronic inflammation as an incidental finding and new clinical scenarios

Mediastinal diffuse large B-cell lymphoma invading the left atrium mimicking coronary artery disease with a mural thrombus

Cardiac lymphoma with first manifestation of recurrent syncope-a case report and literature review

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