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Case Reports
. 2019 Apr 10:2019:7690430.
doi: 10.1155/2019/7690430. eCollection 2019.

Complete Response to R-EPOCH in Primary Cardiac Lymphoma

Kartik Anand  1 , Sai Ravi Pingali  1 , Barry Trachtenberg  2 , Swaminathan Padmanabhan Iyer  1   3
Affiliations
Case Reports

Complete Response to R-EPOCH in Primary Cardiac Lymphoma

Kartik Anand et al. Case Rep Hematol. .

Abstract

Primary cardiac lymphoma (PCL) is a rare extranodal lymphoma involving only the heart and/or the pericardium. Most common presenting signs and symptoms are nonspecific including dyspnea, pericardial effusion, and arrhythmia. Prognosis of PCL patients remain poor compared to non-cardiac lymphoma patients. Since most of the information about PCL comes from case reports or case series, there is no treatment consensus. Anthracycline containing chemotherapy remains main treatment modality which is potentially cardiotoxic. We present a case of PCL that achieved complete remission using R-EPOCH (rituximab, etoposide, prednisone, vincristine, cyclophosphamide, and doxorubicin). We also used dexrazoxane in an effort to reduce cardiotoxicity of chemotherapy.

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Figures

Figure 1
Figure 1
Cardiac MRI showing mass in lateral wall of the left ventricle on T1 and T2 imaging.
Figure 2
Figure 2
(a) H&E section of cardiac biopsy showing diffuse infiltration of large cells. (b) Immunohistochemistry staining positive for CD20.
Figure 3
Figure 3
PET scan showing (a) increased FDG uptake in the cardiac tissue and (b) no extra cardiac FDG uptake.
See this image and copyright information in PMC

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