Primary lymphoma of the heart: report of a case with histological diagnosis of the transvenously biopsied intracardiac tumor

Abstract

Primary cardiac lymphoma is an extremely rare disease and is associated with a high mortality. In most cases, lymphomatous involvement of the heart and/or pericardium occurs as a late manifestation of disseminated disease. Primary cardiac lymphoma is treatable when appropriately diagnosed. We report the case of an immunocompetent 69-year-old patient who presented with signs of dyspnea and a transmural mass infiltrating the apical section of both ventricles. Examination of the tissue obtained by transvenous biopsy revealed high-grade non-Hodgkin's lymphoma of B-cell lineage. The patient was treated successfully with CHOP chemotherapy. This case demonstrates that early diagnosis and intensive chemotherapy might contribute to a better prognosis for patients with malignant lymphoma of the heart.

Primary Cardiac Lymphoma in an Immunocompetent 71-Year-Old Man

“…To our knowledge, only 23 cases of PCL in immunocompetent patients have been reported to date (Table I). [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30] According to these reports, no patient presented with noncardiac lymphomatous localization, but, as in our patient, it was impossible to absolutely exclude noncardiac involvement in the absence of autopsic investiga- Nine of these patients were treated with surgical excision followed by chemotherapy, and 5 of them survived at least 6 months after treatment. No evidence exists concerning the necessity of surgery as an adjunct to chemotherapy in PCL; moreover, in those 9 cases surgery was the final diagnostic step, along with excision as treatment.…”

The Role of Echocardiography in Diagnosing Space-Occupying Lesions of the Heart

“…A method with high diagnostic accuracy is necessary to ensure successful therapy for primary heart lymphoma. 27 Since cytological examination of pericardial fluid is not always sensitive for malignancies, especially for lymphoma, and not all patients are compromised by the pericardial effusion, a transvenous biopsy of the tumor is preferred. 27 Transvenous biopsy has been used successfully to diagnose cardiac lymphomas and is well established for obtaining adequate diagnostic tissue particles.…”

“…27 Since cytological examination of pericardial fluid is not always sensitive for malignancies, especially for lymphoma, and not all patients are compromised by the pericardial effusion, a transvenous biopsy of the tumor is preferred. 27 Transvenous biopsy has been used successfully to diagnose cardiac lymphomas and is well established for obtaining adequate diagnostic tissue particles. 27 The prognosis of primary heart lymphoma is poor due to diagnostic delay and advanced stage of organ infiltration.…”

“…27 Transvenous biopsy has been used successfully to diagnose cardiac lymphomas and is well established for obtaining adequate diagnostic tissue particles. 27 The prognosis of primary heart lymphoma is poor due to diagnostic delay and advanced stage of organ infiltration. 27 The survival is generally less than a month without treatment, but has been prolonged to up to 5 years with chemotherapy and radiation therapy in selected cases.…”

“…27 The prognosis of primary heart lymphoma is poor due to diagnostic delay and advanced stage of organ infiltration. 27 The survival is generally less than a month without treatment, but has been prolonged to up to 5 years with chemotherapy and radiation therapy in selected cases. 28 Metastatic Tumors of the Heart Nonprimary (metastatic) cardiac tumors are about 20 times more common than primary cardiac tumors.…”