18F-FDG PET/CT Finding of Primary Cardiac Lymphoma

Abstract

An 80-year-old woman experienced dyspnea. Cardiac enlargement was detected by chest radiography at a local hospital. She was admitted to our hospital, and echocardiography and CT revealed pericardial effusion and multiple tumor lesions in right atrium. 18F-FDG PET/CT demonstrated multiple nodular accumulations in these tumors (SUVmax, 14.5). Cytologic analysis of the pericardial fluid revealed a diffuse large B-cell lymphoma. Primary cardiac lymphoma (PCL) is rare, and there are few reports about the 18F-FDG PET/CT imaging features of PCLs. In high 18F-FDG uptake in multiple tumors in the right atrium and large pericardial effusion, a PCL should be considered.

FDG PET/CT Showing a Primary Lymphoma of the Sternoclavicular Joint

“…4 Some studies have reported other sites involved in extranodal DLBCL, such as heart, breast, bone, pancreas, and genitourinary system. [5][6][7][8][9] In our case, the primary DLBCL involved the sternoclavicular joint, demonstrating intense FDG uptake on PET/CT. The sternoclavicular joint is commonly involved in rheumatoid arthritis, osteoarthritis, ankylosing spondylitis, gout, and Tietze syndrome.…”

“…The common sites of extranodal DLBCL are gastrointestinal tract, skin, and soft tissues 4 . Some studies have reported other sites involved in extranodal DLBCL, such as heart, breast, bone, pancreas, and genitourinary system 5–9 . In our case, the primary DLBCL involved the sternoclavicular joint, demonstrating intense FDG uptake on PET/CT.…”

Invasive Giant B-Cell Lymphoma Mimicking Fulminant Pulmonary Embolism

“…Furthermore, 18 F-fluorodeoxyglucose PET is considered an invaluable diagnostic tool for revealing and differentiating cardiac infiltrations. 5 6 7 8 Nevertheless, accurate pathological diagnosis is critical to the decision-making process for further disease management.…”

Case Report: Cardiac Involvement by Lymphoma: Rare but Heterogeneous Condition With Challenging Behaviors

“…The less reliable test, in this case, was 18-FDG-PET/CT, which continued to detect a pathological 18-FDG uptake, remaining positive according to Lugano criteria (Deauville score 4). Being aggressive lymphomas, PCLs are usually 18-FDG avid tumors (22), however, the utility of FDG-PET/CT alone in the diagnosis and follow-up of cardiac involvement is controversial, due to the physiological uptake of the heart and the low anatomic resolution of FDG-PET (3,23).…”