Discussion
Diagnosis With Brief Discussion
- Diagnosis
- Intracardiac lymphoma
- Radiologic Findings
- Fig 1-6. CT images show an irregular soft tissue lesion in the Rt atrium with suspicious extension to the inferior vena cava. Note diffuse wall thickening of Rt atrium and mild pericardial effusion. On the coronal CT image, there was no definite evidence of thrombus in the pulmonary artery.
PET/CT images show hypermetabolic uptake in the thickened wall of the Rt atrium. There is also significant FDG uptake in both lateral cervical lymph nodes.
- Brief Review
- Primary cardiac lymphoma is very rare. It accounts for about 1.3% of primary cardiac tumors and 0.5% of extranodal lymphomas. Cardiac lymphomas are most commonly diffuse large cell lymphomas. Patients with cardiac lymphoma commonly show dyspnea, congestive heart failure, pericardial effusion, and hemopericardium. Cardiac arrhythmias and nonspecific electrocardiographic abnormalities are also common, notably AV blocks ranging from first degree to third degree. On CT, cardiac lymphoma manifests as infiltrative epicardial or myocardial mass (often attenuating relative to the myocardium). Cardiac lymphoma shows T1WI hypointensity and T2WI hyperintensity on MRI. The right atrium is most commonly involved. The prognosis of cardiac lymphoma is usually poor with the late diagnosis being a major factor affecting the outcome. Management of cardiac lymphoma is varied, with treatment combination including chemotherapy, radiation therapy, and surgery.
- References
- • JEUDY, Jean, et al. From the radiologic pathology archives: cardiac lymphoma: radiologic-pathologic correlation. Radiographics, 2012, 32.5: 1369-1380.
• VERSLUIS, P. J.; LAMERS, R. J. S.; VAN BELLE, A. F. Primary malignant lymphoma of the heart: CT and MRI features. In: RöFo-Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebenden Verfahren. © Georg Thieme Verlag Stuttgart· New York, 1995. p. 533-534.
• MIGUEL, Carlos E.; BESTETTI, Reinaldo B. Primary cardiac lymphoma. International journal of cardiology, 2011, 149.3: 358-363.
- Keywords