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Case Reports
. 2010 Feb 10:3:1-6.
doi: 10.2147/imcrj.s9269. Print 2010.

Cardiac lymphoma with first manifestation of recurrent syncope-a case report and literature review

Joseph Nybo Lin  1
Affiliations
Case Reports

Cardiac lymphoma with first manifestation of recurrent syncope-a case report and literature review

Joseph Nybo Lin. Int Med Case Rep J. .

Abstract

Cardiac involvement, as an initial presentation of malignant lymphoma is rare. We report a 42-year-old Taiwanese man with frequent syncope. Routine electrocardiography disclosed complete atrioventricular block. Before permanent pacemaker implantation was undertaken, transthoracic echocardiography revealed a solid mass infiltrating the left atrium and interatrial septum. Transesophageal echocardiography proved cardiac neoplasm with biatrial infiltration. Endomyocardial tissue biopsy was performed under angiography guide. Pathology diagnosis unraveled large B-cell lymphoma. Despite aggressive chemotherapy, the patient's condition worsened and he died 2 months later.

Keywords: complete atrioventricular block; primary cardiac lymphoma.

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Figures

Figure 1
Figure 1
Electrocardiogram revealing complete atrioventricular block with junctional escape rhythm (arrows).
Figure 2
Figure 2
An ultrasonogram showing a massive infiltrative thickening of the posterior aspect of the left atrial septum and interatrial septum.
Figure 3
Figure 3
Transesophageal echocardiography showing tumor masses attached to the interatrial septum and protruding into both atrial cavities.
Figure 4
Figure 4
A multislice computed tomogram showing a bulky infiltrative mass about 8.62 cm × 6.45 cm × 9 cm at posterior-lateral and inferior aspect of the left atrium with invasion to myocardium, the interatrial septum, tricuspid valve, right atrium, pericardium, left hilar region, and left pleura (arrow).
Figure 5
Figure 5
FDG-PET revealed remarkably increased glucose metabolism in the RA, interatrial septum, LA, and in a tumor mass protruding from the posterior aspect of pericardium. Abbreviation: FDG-PET, F-labeled 2-deoxyglucose positron electric tomography.
Figure 6
Figure 6
Section showing monotonous proliferation of large centroblast-like lymphoid cells having round to irregular nuclei, with vesicular chromatin and distinct 1 to 3 nucleoli and a moderate amount of cytoplasm (arrow).
See this image and copyright information in PMC

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