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Case Reports
. 2015 Feb 1;8(2):2159-64.
eCollection 2015.

EBV+ diffuse large B-cell lymphoma arising within atrial myxoma in Chinese immunocompetent patient

Xiaoyan Liu  1 , Pu Liu  1 , Jun Li  1
Affiliations
Case Reports

EBV+ diffuse large B-cell lymphoma arising within atrial myxoma in Chinese immunocompetent patient

Xiaoyan Liu et al. Int J Clin Exp Pathol. .

Abstract

The incidence rate of Primary cardiac lymphoma is very low. Primary cardiac lymphoma within myxoma is extremely rare disease. So far, these cases have been reported only eight in the world, which has not reported in Chinese so far. Hence, we reported the unique Chinese case of 52-year-old immunocompetent male with primary Epstein-Barr virus positive diffuse large B-cell lymphoma arising within atrial myxoma, and had no evidence of systemic lymphoma. The patient presented right sided body numbness, arm weakness no incentive and mouth twitch. A transthoracic echocardiogram revealed a large intraatrial mass, attached to the left atrial wall. The mass was removed by open thoracic surgery and subsequently diagnosed as malignant diffuse large B-cell lymphoma with myxoma by histopathology. This was the fourth case of discovered Epstein-Barr virus positive diffuse large B-cell lymphoma in a cardiac myxoma reported so far. The patient has been well by followed up for 5 months without chemotherapy. Now we discuss the importance of histodiagnosis and the proper treatment. Epstein-Barr virus positive diffuse large B-cell lymphoma arising within atrial myxoma is an extraordinary lymphoma for better prognosis, avoiding excessive treatment.

Keywords: Chinese; Epstein-Barr virus; Primary cardiac lymphoma; atrial myxoma; diffuse large B-cell lymphoma; histopathology.

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Figures

Figure 1
Figure 1
Transthoracic echocardiogram shows a 6.0 cm × 3.0 cm atrial myxoma.
Figure 2
Figure 2
A. Excised surgical left atrial tumour macropathology. B. Hematoxylin and eosin stain shows a classic myxoid appearance (× 100) and a higher power magnification image on bottom right corner (× 200). C. Hematoxylin and eosin stain shows lymphoma arising into atrial myxoma (× 50). D. Higher power magnification of pleomorphic lymphoma cells (× 200).
A
A
The spindle cells of left atrial myxoma are positive for calretinin (× 100). (B-E) Immunohistochemical markers show positive staining for CD20 (B, × 400), CD30 (C, × 200), MUM1 (D, × 100) and EBV (E, × 200). (F) In situ hybridization shows lymphoma cells expression EBER (× 200).
See this image and copyright information in PMC

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