Primary Cardiac Lymphoma: Diagnosis and the Impact of Chemotherapy on Cardiac Structure and Function

Can J Cardiol. 2016 Jul;32(7):931.e1-3. doi: 10.1016/j.cjca.2015.09.002. Epub 2015 Sep 12.

Abstract

We report a case of primary cardiac lymphoma presenting as myopericarditis and rapidly deteriorating into biventricular heart failure and ventricular arrhythmias. Computed tomography and cardiac magnetic resonance (CMR) imaging showed extensive myocardial infiltration with typical patterns on tissue characterization CMR images, raising clinical suspicion. Diagnosis was confirmed by myocardial histologic examination. Marked regression of tumor burden was apparent after 6 cycles of anthracycline-based chemotherapy. This case illustrates that a high degree of suspicion for this rare entity is mandated to institute timely treatment. Rapid tumor lysis may induce life-threatening acute cardiac decompensation that requires intensive monitoring and support therapy.

Publication types

  • Case Reports

MeSH terms

  • Antibodies, Monoclonal, Murine-Derived / therapeutic use
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Arrhythmias, Cardiac / drug therapy
  • Arrhythmias, Cardiac / etiology
  • Cyclophosphamide / therapeutic use
  • Doxorubicin / therapeutic use
  • Heart Failure / drug therapy
  • Heart Failure / etiology
  • Heart Neoplasms / drug therapy*
  • Heart Neoplasms / pathology*
  • Humans
  • Lymphoma, Large B-Cell, Diffuse / drug therapy*
  • Lymphoma, Large B-Cell, Diffuse / pathology*
  • Magnetic Resonance Imaging, Cine
  • Male
  • Middle Aged
  • Myocarditis / drug therapy
  • Myocarditis / etiology
  • Pericarditis / drug therapy
  • Pericarditis / etiology
  • Prednisone / therapeutic use
  • Rituximab
  • Vincristine / therapeutic use

Substances

  • Antibodies, Monoclonal, Murine-Derived
  • R-CHOP protocol
  • Rituximab
  • Vincristine
  • Doxorubicin
  • Cyclophosphamide
  • Prednisone