Primary Cardiac Lymphoma Justin A. Mariani, Mark A. Dawson, Sharon Avery, and Andrew J. Taylor J. Am. Coll. Cardiol.

2010;55;e23 doi:10.1016/j.jacc.2009.09.070

This information is current as of March 29, 2010

The online version of this article, along with updated information and services, is located on the World Wide Web at: http://content.onlinejacc.org/cgi/content/full/55/13/e23

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Journal of the American College of Cardiology 2010 by the American College of Cardiology Foundation Published by Elsevier Inc.

Vol. 55, No. 13, 2010 ISSN 0735-1097/10/$36.00 doi:10.1016/j.jacc.2009.09.070

IMAGES IN CARDIOLOGY

Primary Cardiac Lymphoma

Justin A. Mariani, MBBS, PHD,* Mark A. Dawson, MBBS, Sharon Avery, MBBS, Andrew J. Taylor, MBBS, PHD* Melbourne, Australia

From the *Heart Centre, The Alfred Hospital, Melbourne, Victoria, Australia; Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia; and the Department of Clinical Haematology, The Alfred Hospital, Melbourne, Victoria, Australia. Manuscript received September 14, 2009; accepted September 24, 2009.

previously well, immunocompetent 76-year-old woman with syncope and dyspnea was referred after a chest computed tomography examination detected a right atrioventricular (AoV) mass. Transesophageal echocardiography (A and B) demonstrated a large nonspecic mass involving the right heart. Subsequent subxiphisternal biopsy conrmed a diffuse large B-cell lymphoma. Positron emission tomography conrmed cardiac isolation. Cardiac magnetic resonance (CMR) imaging (C and D) gradient echo (bright-blood) cine sequences demonstrated encroachment of the mass into the right heart (white arrows), including a pedunculated segment within the right atrium (RA) (black arrow). There was evidence of lymphomatous encirclement of the ascending aorta (G to I), with the right coronary artery seen traversing through the malignancy (I, white arrow). Tagged CMR imaging sequences demonstrated cardiac musculature integrity before chemotherapy. Follow-up CMR images (E and F) obtained 6 months after aggressive chemotherapy (CHOP-14 plus rituximab) revealed successful treatment but persistent right ventricular (RV) dilation. At 5 years, the patient remains in remission and without heart failure.
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Primary Cardiac Lymphoma Justin A. Mariani, Mark A. Dawson, Sharon Avery, and Andrew J. Taylor J. Am. Coll. Cardiol. 2010;55;e23 doi:10.1016/j.jacc.2009.09.070 This information is current as of March 29, 2010
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