Primary Cardiac Lymphoma Presenting With Atrioventricular Block

Abstract

Primary cardiac lymphomas (PCL) are extremely rare. Clinical manifestations may be variable and are attributed to location. Here, we report on a case of PCL presenting with atrioventricular (AV) block. A 55 year-old male had experienced chest discomfort with unexplained dyspnea and night sweating. His initial electrocardiogram (ECG) revealed a first degree AV block. Along with worsening chest discomfort and dyspnea, his ECG changed to show second degree AV block (Mobitz type I). Computed tomography (CT) scan showed a cardiac mass (about 7 cm) and biopsy was performed. Pathologic finding confirmed diffuse large B-cell lymphoma. The patient was treated with multi-drug combination chemotherapy (R-CHOP: Rituximab, cyclophoshamide, anthracycline, vincristine, and prednisone). After treatment, ECG changed to show normal sinus rhythm with complete remission on follow-up CT scan.

Primary Cardiac Lymphoma: Echocardiography and F‐18‐Fluorodeoxyglucose Positron Emission Tomography in Selection of a Biopsy Site

“…A common presentation of primary cardiac lymphoma is arrhythmia, which was presumed to be the cause of the palpitation and syncope in this case. 10 However, we could not detect any arrhythmia, such as atrioventricular block, and could not identify the causes.…”

Multimodality Imaging Can Help to Doubt, Diagnose and Follow-Up Cardiac Mass

“…Although there have been case reports and small case series of B cell lymphomas presenting as AV block,3)4) the first case is one of the first to demonstrate that T cell lymphomas can also present as such. T-LBL differs from other types of B cell lineage lymphomas with its distinct clinical and biological features, such as high male predominance, and particularly, preponderance of mediastinal involvement and lower chance of complete remission despite adequate chemotherapy 5).…”

A Case of Primary Cardiac Lymphoma Mimicking Acute Coronary and Aortic Syndrome

“…The common arrhythmia was atrial arrhythmias and AV block 4). We already experienced one case of PCL presenting with AV block 6). However, VT was rarely reported,7-9) probably because VT is a life-threatening arrhythmia that can lead to sudden cardiac death.…”