Primary Cardiac Diffuse Large B-cell Lymphoma Promptly and Safely Diagnosed with Pericardial Effusion Cytology

Abstract

Primary cardiac lymphoma is a rare condition with a poor prognosis, and patients are at risk for sudden cardiac death. A prompt diagnosis and early treatment are therefore essential. A 68-year-old woman was admitted for shortness of breath and peripheral edema. Echocardiograms showed massive pericardial effusion and a mass on the free wall of the right atrium and ventricle. Subsequent pericardial effusion cytology revealed diffuse large B-cell lymphoma. We started chemotherapy with rituximab and achieved a good clinical course. This case is made unique by the use of pericardial effusion cytology, which allowed us to diagnose primary cardiac lymphoma promptly and safely.

A rare primary pericardial DLBCL masquerading as an unexplained malignant pleural effusion in an elderly woman: A case report

“…Malignant effusion and supportive care remained significant in multivariate analyses. The ancillary method described was used to confirm the morphological presence of lymphomatous effusions in some cases [ 2 , 3 , [7] , [8] , [9] , [10] , 12 , 17 ].…”

“…Pericardial involvement with secondary pleural effusion is extremely rare [ 7 ]. Pericardial effusion is the most common presentation [ 2 , 3 , 5 , 6 , [8] , [9] , [10] , [11] , [12] ]. Pericardial lymphoma's clinical presentation is nonspecific and depends on tumour size and location.…”

Secondary Cardiac Lymphoma Presenting as Sick Sinus Syndrome and Atrial Fibrillation Which Required Leadless Pacemaker Implantation

“…These include transesophageal echocardiography-guided biopsy, transvenous angiography-guided biopsy, mediastinoscopic biopsy, and thoracoscopic biopsy ( 2 ). In case of pericardial effusion, cytological examination is useful to prevent the risk of embolism through direct biopsy ( 11 ).…”