Primary cardiac lymphoma

Abstract

Objective: To report a rare autopsy case of primary cardiac lymphoma with microscopical involvements of extracardiac organs in an immunocompetent man.

Methods: An autopsy case of primary cardiac lymphoma in a 70-year-old man was examined grossly, microscopically and immunohistochemically. In addition, in situ hybridization for Epstain-Barr virus was performed.

Results: Clinically, a tumor was at first found only in the heart by various imaging techniques but tumor involvements were noted in chest and abdominal organs as the disease progressed. He died of cardiac failure six months after the first presentation. An autopsy revealed a tumor formation only in the right atrium and right ventricle of the heart. Histological and immunohistochemical studies showed that the cardiac tumor was diffuse large B cell lymphoma of non-germinal center B-cell like type. In addition to the heart, the tumor cells were found to microscopically involve lungs and peritoneal and retroperitoneal fat tissue of several organs. Epstein-Barr virus protein and DNA were negative by immunohistochemistry and in situ hybridization.

Conclusions: It was suggested that primary cardiac lymphoma may involve extracardiac organs as the disease progresses and that it may occur in immunocompetent persons.