Diffuse involvement of the heart and great vessels in primary cardiac lymphoma

Abstract

Primary cardiac lymphoma (PCL) is an extremely rare disorder. In this report, a 57-year-old male with diffuse large B-cell lymphoma involving the heart and great vessels is presented. Trans-thoracic echocardiography was the first modality used to establish the diagnosis. Fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) showed diffuse increased metabolic activity of the heart walls and hypermetabolic lesions occupying cardiac chambers in some areas. The patient underwent systemic chemotherapy, and after 13 days, a marked regression of the tumour mass was evident based on echocardiographic examination. After completing six R-CHOP chemotherapy treatments, PET imaging was planned to control the residual mass, but the patient was intubated due to pneumonia that developed after the sixth chemotherapy session and subsequently died due to sepsis.

Added Value of 99mTc-HMPAO–Labeled Leukocyte SPECT/CT in the Characterization and Management of Patients with Infectious Endocarditis

“…However, 18 F-FDG uptake is observed in a variety of benign and malignant conditions such as inflammation or tumors (31), thus reducing its specificity. Moreover, special caution should be used in the interpretation of 18 F-FDG uptake in the cardiac region, because of the high number of possible causes other than IE for a positive finding: recent thrombi (32), soft atherosclerotic plaques (33), vasculitis (34), primary and metastatic cardiac tumors (35,36), or simply a postsurgical inflammatory reaction (37). In clinical routine, focal areas of 18 F-FDG uptake at the heart in the absence of IE are quite commonly observed (Paola A. Erba, unpublished data, 2011; Fig.…”

Extensive Extranodal Involvement of Rare Sites in Non Hodgkin’s Lymphoma Detected on 18F- FDG PET-CT: A Case Report

“…The involvement is usually revealed by cardiac complications and is associated with a poor prognosis [21,22]. Few cases of cardiac involvement in NHL have been reported, both primary and metastatic, detected by 18 F-FDG PET-CT [9][10][11]. Julian et al reported two cases of NHL with cardiac involvement (apical septum, right ventricle and right auricle) detected by 18 F-FDG PET-CT that allowed an early diagnosis and chemotherapy, therefore, improving the survival [9].…”

“…The role of 18 F-FDG PET-CT in detection, staging and restaging of patients with extranodal involvement in NHL has also been reported in the literature [2,3]. Multiple isolated cases with extranodal involvement of NHL, detected on PET-CT, have been previously reported [8][9][10][11]. Here, we report a rare case of extranodal NHL involving multiple organs namely heart, bilateral kidneys, bowel, and left testis, in addition to mesenteric and retroperitoneal lymph nodes which were detected on 18 F-FDG PET-CT.…”

Non-invasive imaging and monitoring cardiotoxicity of cancer therapeutic drugs

“…However, fluorine-18-fluorodeoxyglucose (FDG) PET imaging can be useful in diagnosing and monitoring response to treatment of primary cardiac lymphoma, which will be apparent as hypermetabolic areas within the myocardium, 46,47 FDG-PET has also been able to evaluate for metastatic pericardial involvement. 48 There has been limited investigation applying cardiac PET to monitor for ARC in humans.…”