Primary cardiac lymphoma: two cases and a review of literature
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CASE REPORT
Open Access
Primary cardiac lymphoma: two cases and a review of literature Karolis Jonavicius1,2,5*, Kestutis Salcius2, Raimundas Meskauskas3, Nomeda Valeviciene4, Virgilijus Tarutis2,5 and Vytautas Sirvydis2
Abstract Background: Primary cardiac lymphoma is one of the rarest tumours of the heart. It belongs to the extra-nodal non-Hodgkin’s lymphomas. The most common type of this tumour is diffuse large B cell lymphoma. Usually, right atrium and right ventricle are involved. This tumour is fatal unless diagnosed and treated in time. In this article two female patients who were diagnosed with primary cardiac lymphoma and treated at our clinic are described. The first patient went to remission after the treatment, while the second patient died. The goals of this article are to show the difficulties of diagnosing and treating this disease, the role of cardiac surgery in its treatment and to raise awareness of this disease. Case reports: In this article two female patients who were diagnosed with primary cardiac lymphoma and treated at our clinic are described. The first patient went to remission after the treatment, while the second patient died. Conclusions: Primary cardiac lymphoma is a very rare disease. At the moment the most effective treatment is chemotherapy. Palliative surgery may be necessary to correct hemodynamics when venous blood flow to the lungs is disturbed. Keywords: Primary cardiac lymphoma, Heart tumour, Large B cell lymphoma
Background Primary cardiac lymphoma (PCL) is a rare malignant disease. A. Johri et al. state that PCL composes just 1.3 % of all cardiac tumours [1]. L. Zhong et al. write that PCL composes only 0.5 % of all extranodal lymphomas [2]. The most common histological type of PCL is large B cell lymphoma [2, 3]. PCL is fatal, unless it is diagnosed and treated in time [4]. Patients usually die within few months after being diagnosed with PCL [5–7]. In this article two patients diagnosed with PCL and treated at our clinic are presented. Case reports Patient 1, a 48 year old female, who had a history of progressive heart failure, dyspnoea at rest and cyanosis for three weeks prior to hospitalization. The patient had no complaints of fever above 38 C, night sweating or loss of * Correspondence: [email protected] 1 Faculty of Medicine, Vilnius University, Vilnius, Lithuania 2 Department of Cardiovascular Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania Full list of author information is available at the end of the article
more than 10 % of body weight over a period of six or less (B symptoms). On the day of hospitalization a transthoracic echocardiography (TTE) was performed. An inhomogeneous tumour was found in both atria. It was almost closing the orifice of the tricuspid valve (the diameter of the tricuspid valve orifice was 2.38 cm and the diameter of the part of the tumour closing the orifice was 2.25 cm) and penetrating the left ventricle via the interventricular septum. Complete blood count (CBC) and coagulation profile test (CPT) were within
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