Successful treatment of a patient with cardiac lymphoma who presented with a complete atrioventricular block

Abstract

A patient with primary cardiac lymphoma, which is very rare, generally is regarded to have a poor prognosis. We herein report a patient with cardiac lymphoma who was treated successfully by systemic chemotherapy and radiotherapy using a pacemaker to control the complete atrioventricular (A-V) block. A 70-year-old man had a syncope caused by a complete A-V block. An echocardiogram, a computed tomographic scan, and magnetic resonance imaging of his chest showed a cardiac tumor. At this time, a biopsy of the cardiac tumor disclosed malignant lymphoma (diffuse large cell type, B cell type). The patient was thus treated with systemic chemotherapy and radiotherapy and, as a result, achieved a complete remission with a disappearance of the A-V block. Recently, several successful outcomes involving primary cardiac lymphoma have been reported because of the progress in diagnostic techniques including echocardiography, computed tomographic scanning, and magnetic resonance imaging, as well as improvement in the therapy of malignant lymphoma. Our clinical experience indicated that an early and accurate diagnosis combined with the appropriate therapy can thus help in obtaining a long survival in patients with primary cardiac lymphoma.

A unique atrial primary cardiac lymphoma mimicking myxoma presenting with embolic stroke: a case report

“…The finding of EBV nucleic acid sequences in the malignant cells by in situ hybridization has not been previously observed in PCL in immunocompetent patients. 13,14 However, B-cell ALCL has been associated with EBV infection in some cases. 15,16 A unique aspect of this case is the intimate association of the malignant lymphoid cells with a mural fibrin thrombus, without cardiac wall invasion.…”

Primary Malignancies of the Heart and Pericardium

“…Elbardissi et al reported that atrial fibrillation accompanied 16% of malignant cardiac tumors and ventricular tachycardia was present in 7%. Complete atrioventricular block has been described . Another common finding is electrical alternans characterized by beat‐to‐beat alternation of the QRS complex due to swinging heart within a large pericardial effusion.…”

“…Complete atrioventricular block has been described. 16,17 Another common finding is electrical alternans characterized by beat-to-beat alternation of the QRS complex due to swinging heart within a large pericardial effusion.…”

Primary Cardiac Lymphoma Presenting With Atrioventricular Block

“…In the English literature, about 20 cases presenting with AV block have been described. Among those cases, a pacemaker was inserted in patients with high degree AV block 16-18). To the best of our knowledge, this case is the first to report on PCL with AV block in the Korean literature.…”