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European Heart Journal Advance Access originally published online on October 24, 2005
European Heart Journal 2006 27(13):1538; doi:10.1093/eurheartj/ehi593
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© The European Society of Cardiology 2006. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Cardiac lymphoma

Dimitrios A. Stakos1,*, Dimitrios I. Xatseras1 and Harisios Boudoulas2

1 Division of Cardiology, Democritus University of Thrace, University Hospital of Alexandroupolis, Alexandroupolis 68100, Greece
2 Center for Clinical Research, Foundation of Biomedical Research, Academy of Athens, Athens, Greece

* Corresponding author. E-mail address: dimstakos{at}yahoo.com

A 76-year-old immunocompetent man with worsening shortness of breath presented at our institution. The patient had jugular venous distention, lower-extremity oedema, and hepatomegaly; the lungs were clear. Electrocardiogram showed atrial fibrillation with slow ventricular response of 35–40 b.p.m. Therapy with dobutamine and intravenous diuretics was initiated, but the patient remained symptomatic. Transthoracic echocardiography and contrast-enhanced chest-computed tomography revealed the presence of a large globular mass, filling almost the entire right atrium (arrow in Panels A and B). The tumour invaded the superior vena cava.

The patient died suddenly within 24 h from hospitalization. At autopsy, a large tumour was found, occupying almost the entire right atrium (arrow in Panel C). Part of the left atrium and part of the septum were also involved. Histological examination of tumour demonstrated a high-grade B-cell non-Hodgkin lymphoma. Immunohistochemical study of the tumour cells was positive for CD79a (Panel D), CD45, and CD20. There was no evidence of lymphoma in bone marrow and other organs including thyroid gland, stomach, intestine, lung, spleen, and liver at histological examination performed after the autopsy. The present case incorporates several characteristics of primary cardiac lymphoma. Primary cardiac lymphoma is defined as an extranodal B-cell non-Hodgkin's lymphoma exclusively or mainly located in the heart and/or the pericardium, accounting for less than 2% of primary cardiac tumours. Primary cardiac lymphoma should be considered in patients with a cardiac mass, atrioventricular conduction defects, and refractory heart failure. Early diagnosis and treatment of this rare malignancy is imperative for survival. RV, right ventricle; Ra, right atrium.

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This Article
Right arrow FREE Full Text (PDF) Freely available
Right arrow All Versions of this Article:
27/13/1538    most recent
ehi593v1
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Right arrow Articles by Stakos, D. A.
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Right arrow Articles by Stakos, D. A.
Right arrow Articles by Boudoulas, H.
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