Primary lymphoma of the heart. A case report

Chou, S.T.; Arkles, Barry; Gill, Gary D.; Pinkus, Newman B.; Parkin, A.; Hicks, John

doi:10.1002/1097-0142(19830815)52:4<744::aid-cncr2820520430>3.0.co;2-2

Cited by 57 publications

(17 citation statements)

References 11 publications

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“…Primary cardiac lymphoma remains asymptomatic until it produces a mass effect when the tumor obstructs cardiac output or causes local invasion, embolization, or systemic manifestations. Chest pain is the most common symptom occurring in 26% [6,10,18,27,28,29,30,31,38], dyspnea in 20% [7,8,9,28,34,36,37], superior vena caval syndrome in 9% [3,15,17] Chest X-ray is not usually helpful for the detection of cardiac tumor. It can reveal non-specific signs such as pleural effusion and/or cardiomegaly.…”

Section: Discussionmentioning

confidence: 99%

“…Less invasive procedures may be used in critically ill patients, small children, or preg- nant women and may provide diagnosis in 23% of cases. Three cases were diagnosed by means of endomyocardic biopsy [10,25,26]. Transvenous biopsies under simultaneous fluoroscopic and echocardiographic guidance represent a minimally invasive procedure including leftside samples [8] and provided diagnosis in five patients [8,12,18,20,41].…”

Section: Discussionmentioning

confidence: 99%

“…It is an extranodal lymphoma involving only the heart and/or the pericardium [5]. We report 3 cases of primary cardiac lymphoma and review 35 cases from the literature [1,2,3,6,7,8,9,10,11,12,15,17,18,19,20,21,22,23,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,41].…”

Section: Introductionmentioning

confidence: 99%

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Primary cardiac lymphoma in immunocompetent patients: a report of three cases and review of the literature

et al. 2002

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Primary cardiac lymphoma is an extranodal non-Hodgkin's lymphoma exclusively located in the heart and/or pericardium, extremely rare in immunocompetent patients, and more frequent in immunodepressed patients. We present 3 retrospectives cases of primary cardiac lymphoma in immunocompetent patients and review 35 cases reported in the literature. Two patients were adults and one was a child. Primary cardiac lymphoma presented with constitutional symptoms in two cases and superior vena caval syndrome in one case. Diagnosis of a tumor mass was made in all cases by transthoracic echocardiography. Primary cardiac lymphoma arose in the heart right chambers in two cases. Histological diagnoses, obtained after thoracotomy, were diffuse large B-cell lymphoma in two cases, and Burkitt's lymphoma in one case. All three cases received chemotherapy, combined with radiotherapy in one patient. Of our patients, 2 are alive and asymptomatic 12 months and 33 months after diagnosis. In conclusion, diagnosis of primary cardiac lymphoma is difficult due to non-specific clinical manifestations and should be considered in patients with a cardiac mass sometimes with pericardial effusion. It is confirmed using transthoracic echocardiography and magnetic resonance imaging and certified using cytology or open biopsy. The only effective treatment is chemotherapy, but prognosis remains poor.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Primary cardiac lymphoma in immunocompetent patients: a report of three cases and review of the literature

et al. 2002

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“…12 Two patients were living without evidence of lymphoma at 6 months 1,6 ; however, no followup information was reported, so their final outcomes …”

Section: A B Cmentioning

confidence: 99%

Recurrent Primary Cardiac Lymphoma on Aortic Valve Allograft: Implications for Therapy

Farah¹,

Chiles²

2014

Texas Heart Institute Journal

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P rimary lymphoma of the heart is rarely reported.1 Isolated allograft-associated cardiac lymphoma is even more unusual and has a poor prognosis.2,3 We present the case of a man who had initially presented with endocarditis and was later diagnosed with diffuse large B-cell lymphoma (DLBCL) on his 2 aortic valve allografts. In addition to discussing the patient's case, we review the sparse literature on the topic. Case ReportIn February 2007, a 56-year-old man presented at our institution with Staphylococcus aureus endocarditis complicated by multiple septic emboli and severe aortic regurgitation. He underwent aortic valve replacement with an allograft and had concomitant coronary artery bypass grafting. The surgical specimen of his native valve was calcified and showed active endocarditis without tumor. The patient had an uneventful recovery and was managed for heart failure symptoms (New York Heart Association functional class II/III) for approximately 3½ years. In January 2011, at age 60 years, he presented with fever, weight loss, and worsening heart failure. Results of multiple blood cultures were negative; however, echocardiograms revealed an aortic valve mass (Fig. 1A). The patient was treated for presumed culture-negative endocarditis. Because of progressive aortic regurgitation, he underwent repeat aortic valve replacement with a new allograft. The surgical specimen of the explanted valve displayed DLBCL. Biopsy samples were taken from the native tissue surrounding the allograft, and no lymphoma was found (Fig. 2). Computed tomography of the chest, abdomen, and pelvis were performed, as was a bone marrow biopsy. A blood-specimen DNA probe was positive for Epstein-Barr virus (EBV), by means of polymerase chain reaction (PCR). No evidence of systemic lymphoma was found. Because of the patient's poor functional status from debility, prior strokes, and congestive heart failure, no systemic chemotherapy was given. He had a protracted rehabilitation and, in September 2011, was admitted again with fever. Results of blood cultures were negative. Transesophageal echocardiograms revealed a mass around the aortic valve that impinged on the left main coronary artery (Fig. 1B). In January 2012, one year after the initial diagnosis Case Reports

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“…Since cytologic examination of pericardial fluid is not always sensitive for malignancies, especially for lymphoma, and, moreover, our patient was not compromised by the pericardial effusion, we preferred a transvenous biopsy of the tumor in the right ventricle. This technique is well established for obtaining adequate diagnostic tissue particles and has been used successfully to diagnose cardiac lymphomas [2,4,7]. In this case, histologic and immunochemical examination of biopsy material confirmed the diagnosis of malignant lymphoma.…”

Section: Discussionmentioning

confidence: 85%

Primary lymphoma of the heart: report of a case with histological diagnosis of the transvenously biopsied intracardiac tumor

Daus

Bay

Harig

et al. 1998

Annals of Hematology

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Primary cardiac lymphoma is an extremely rare disease and is associated with a high mortality. In most cases, lymphomatous involvement of the heart and/or pericardium occurs as a late manifestation of disseminated disease. Primary cardiac lymphoma is treatable when appropriately diagnosed. We report the case of an immunocompetent 69-year-old patient who presented with signs of dyspnea and a transmural mass infiltrating the apical section of both ventricles. Examination of the tissue obtained by transvenous biopsy revealed high-grade non-Hodgkin's lymphoma of B-cell lineage. The patient was treated successfully with CHOP chemotherapy. This case demonstrates that early diagnosis and intensive chemotherapy might contribute to a better prognosis for patients with malignant lymphoma of the heart.

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Primary lymphoma of the heart. A case report

Cited by 57 publications

References 11 publications

Primary cardiac lymphoma in immunocompetent patients: a report of three cases and review of the literature

Primary cardiac lymphoma in immunocompetent patients: a report of three cases and review of the literature

Recurrent Primary Cardiac Lymphoma on Aortic Valve Allograft: Implications for Therapy

Primary lymphoma of the heart: report of a case with histological diagnosis of the transvenously biopsied intracardiac tumor

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