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A Vanishing Cardiac Mass

      Key Words:

      Primary cardiac lymphoma is defined as a non-Hodgkin lymphoma involving only the heart and/or pericardium and is a rare malignancy.
      • McAllister HA
      • Fenoglio JJ
      Tumors of the cardiovascular system.
      Patients may present with signs of heart failure, cardiac tamponade, or arrhythmias, depending on the site of the tumor.
      • Roller MB
      • Manoharan A
      • Lvoff R
      Primary cardiac lymphoma.
      Prognosis is poor due to diagnostic delay and relevance of the site of disease.
      Case: “A 55-year-old man presented with a 2 month history of exertional chest pain, dyspnea, and recurrent fever. One month prior he also had evidence of a myocardial infarction with ST elevations and positive troponins. At time of admission his vital signs were stable. Transesophageal echocardiography was performed due to suspicion of bacterial endocarditis and showed huge bilateral atrial enlargement and a nonhomogeneous mass that distorted the atrial architecture. The mass externally compressed the superior and inferior vena cava and aortic arch, and infiltrated the right atria and pericardial space (Figure 1).” Endopericardial biopsy showed a subxiphoid approach confirmed large B-cell lymphoma. He was treated with external beam radiation (40 Gy) and CHOP chemotherapy (cyclophosphamide, doxorubicin, vincristine, and prednisone). Follow-up transesophageal echocardiography at 8 months showed no evidence of tumor (Figure 2).
      Figure thumbnail gr1
      FIGURE 1TEE showed a huge atrials, non-homogenous irregular mass causing external pressure to SVC, IVC and arch of aorta.
      Figure thumbnail gr2
      FIGURE 2Follow up TEE at 8 months after chemotherapy showed no evidence of tumor.

      REFERENCES

        • McAllister HA
        • Fenoglio JJ
        Tumors of the cardiovascular system.
        in: McAllister HA Fenoglio JJ Atlas of Tumor Pathology, 2nd Series, Fascicle 15. Armed Forces Institute of Pathology, Washington, DC1978: 99-100
        • Roller MB
        • Manoharan A
        • Lvoff R
        Primary cardiac lymphoma.
        Acta Haematol (Basel). 1991; 85: 47-48