Primary Lymphoma of the Heart: A Case Report of Surgical Treatment and Review of the Literature
Background: The incidence of heart tumors is the lowest in all known tumors. Primary cardiac tumors are especially rare, with an incidence of 0.056% according to autopsy reports. The most common type is myxoma, which account for nearly 70%-80% of them. Only 10% of primary cardiac tumors are malignant, approximately 95% of which are sarcomas, whereas the primary cardiac lymphomas (PCLs) are merely 1%.
Case Presentation: The present study reported a case of PCL with bilateral renal involvement. The patient received right atrial tumor excision and cardiac pacemaker implantation because of obstruction of the right ventricular outflow tract and third degree atrioventricular (AV) block. Primary diffuse large B-cell lymphoma (DLBCL) was diagnosed through pathological examination; complete remission (CR) was achieved after timely treatment with chemotherapy and autologous peripheral blood stem
Conclusions: PCL is a very rare disease with highly malignancy. With nonspecific clinical features, the diagnosis is mainly done by histopathological and immunohistochemical staining. At the moment, the most effective treatment is chemotherapy. Palliative surgery may be necessary to correct hemodynamics when outflow is obstructed. The specific location, size, and proximity of the tumor 1ead to the prognosis. Once the cardiac conduction system was involved, electrocardiography (ECG) showed high
Baikoussis NG, Papakonstantinou NA, Dedeilias P, et al. 2015. Cardiac tumors: a retrospective multicenter institutional study. J BUON 20(4):1115-23.
Basso C, Valente M, Thiene G, eds. c2013. Cardiac tumor pathology. New York: Humana Press.
Ceresoli GL, Ferreri AJ, Bucci E, Ripa C, Ponzoni M, Villa E. 1997. Primary cardiac lymphoma in immunocompetent patients: diagnostic and therapeutic management. Cancer 80(8):1497-506.
Coiffier B, Lepage E, Briere J, et al. 2002. CHOP chemotherapy plus rituximab compared with CHOP alone in elderly patients with diffuse large-B-cell lymphoma. N Engl J Med 346(4):235-42.
Curtsinger CR, Wilson MJ, Yoneda K. 1989. Primary cardiac lymphoma. Cancer 64(2):521-5.
Fukunaga H, Tatewaki Y, Mutoh T, et al. 2018. A case of low-grade primary cardiac lymphoma with pericardial effusion diagnosed by combined 18F-fluorodeoxyglucose positron emission tomography and computed tomography (FDG-PET/CT) imaging and effusion cytology. Am J Case Rep 19:292-5.
Ito M, Tsuchiyama J, Chinushi M, Kodama M, Aizawa Y. 2005. Transient giant negative T waves associated with cardiac involvement of diffuse large B-cell lymphoma. Circulation 112(20):e322-3.
Lam KY, Dickens P, Chan AC. 1993. Tumors of the heart. A 20 year experience with a review of 12,485 consecutive autopsies. Arch Pathol Lab Med 117(10):1027-31.
Lowenthal DA, Straus DJ, Campbell SW, Gold JW, Clarkson BD, Koziner B. 1988. AIDS-related lymphoid neoplasia. The Memorial Hospital experience. Cancer 61(11):2325-37.
Minamimoto R, Morooka M, Kubota K, et al. 2011. Value of FDG-PET/CT using unfractionated heparin for managing primary cardiac lymphoma and several key findings. J Nucl Cardiol 18(3):516-20.
Nonami A, Takenaka K, Kamezaki K, et al. 2007. Successful treatment of primary cardiac lymphoma by rituximab-CHOP and high-dose chemotherapy with autologous peripheral blood stem cell transplantation. Int J Hematol 85(3):264-6.
Petrich A, Cho SI, Billett H. 2011. Primary cardiac lymphoma: an analysis of presentation, treatment, and outcome patterns. Cancer 117(3):581-9.
Svec A, Rangaiah M, Giles M, Jaksa R, McAulay KA. 2012. EBV+ diffuse large B-cell lymphoma arising within atrial myxoma. An example of a distinct primary cardiac EBV+ DLBCL of immunocompetent patients. Pathol Res Pract 208(3):172-6.
Tanaka PY, Atala MM, Pereira J, Caterino-de-Araujo A. 2009. Primary effusion lymphoma with cardaic involvement in HIV positive patient-complete response and long survival with chemotherapy and HAART. J Clin Virol 44(1):84-85.
Travis WD, Brambilla E, Burke AP, Marx A, Nicholson AG, eds. 2015. WHO classification of tumours of the lung, pleura, thymus and heart. Lyon: IARC Press.
Wang Q, Zhu J. 2014. Diagnosis and treatment of primary cardiac lymphoma in China. J Guangxi Med 36(5):671-3.
Yoshihara S, Naito M, Tanioka F, Matsunaga M. 2013. A case of primary cardiac lymphoma: in vivo imaging and pathologic correlation. Eur Heart J Cardiovasc Imaging 14(10):1027.
Zaharia L, Gill PS. 1991. Primary cardiac lymphoma. Am J Clin 0ncol 14(2):142-5.
Zhong L, Yang S, Lei K, Jia Y. 2013. Primary cardiac lymphoma: a case report and review of the literature. Chin German J Clin Oncol 12(1):43-5.
Author Disclosure & Copyright Transfer Agreement
In order to publish the original work of another person(s), The Heart Surgery Forum® must receive an acknowledgment of the Author Agreement and Copyright Transfer Statement transferring to Forum Multimedia Publishing, L.L.C., a subsidiary of Carden Jennings Publishing Co., Ltd. the exclusive rights to print and distribute the author(s) work in all media forms. Failure to check Copyright Transfer agreement box below will delay publication of the manuscript.
A current form follows:
The author(s) hereby transfer(s), assign(s), or otherwise convey(s) all copyright ownership of the manuscript submitted to Forum Multimedia Publishing, LLC (Publisher). The copyright transfer covers the exclusive rights to reproduce and distribute the article and the material contained therein throughout the world in all languages and in all media of expression now known or later developed, including but not limited to reprints, photographic reproduction, microfilm, electronic data processing (including programming, storage, and transmission to other electronic data record(s), or any other reproductions of similar nature), and translations.
However, Publisher grants back to the author(s) the following:
- The right to make and distribute copies of all or part of this work for use of the author(s) in teaching;
- The right to use, after publication in The Heart Surgery Forum, all or part of the material from this work in a book by the author(s), or in a collection of work by the author(s);
- The royalty-free right to make copies of this work for internal distribution within the institution/company that employs the author(s) subject to the provisions below for a work-made-for-hire;
- The right to use figures and tables from this work, and up to 250 words of text, for any purpose;
- The right to make oral presentations of material from this work.
Publisher reserves the right to grant or refuse permission to third parties to republish all or part of the article or translations thereof. To republish, such third parties must obtain written permission from the Publisher. (This is in accordance with the Copyright Statute, United States Code, Title 17. Exception: If all authors were bona fide officers or employees of the U.S. Government at the time the paper was prepared, the work is a “work of the US Government” (prepared by an officer or employee of the US Government as part of official duties), and therefore is not subject to US copyright; such exception should be indicated on signature lines. If this work was prepared under US Government contract or grant, the US Government may reproduce, royalty-free, all or portions of this work and may authorize others to do so, for official US Government purposes only, if the US Government contract or grant so requires.
I have participated in the conception and design of this work and in the writing of the manuscript and take public responsibility for it. Neither this manuscript nor one with substantially similar content under my authorship has been published, has been submitted for publication elsewhere, or will be submitted for publication elsewhere while under consideration by The Heart Surgery Forum, except as described in an attachment. I have reviewed this manuscript (original version) and approve its submission. If I am listed above as corresponding author, I will provide all authors with information regarding this manuscript and will obtain their approval before submitting any revision. I attest to the validity, accuracy, and legitimacy of the content of the manuscript and understand that Publisher assumes no responsibility for the validity, accuracy, and legitimacy of its content. I warrant that this manuscript is original with me and that I have full power to make this Agreement. I warrant that it contains no matter that is libelous or otherwise unlawful or that invades individual privacy or infringes any copyright or other proprietary right. I agree to indemnify and hold Publisher harmless of and from any claim made against Publisher that relates to or arises out of the publication of the manuscript and agree that this indemnification shall include payment of all costs and expenses relating to the defense of any such claim, including all reasonable attorney’s fees.
I warrant that I have no financial interest in the drugs, devices, or procedures described in the manuscript (except as disclosed in the attached statement).
I state that the institutional Human Subjects Committee and/or the Ethics Committee approved the clinical protocol reported in this manuscript for the use of experimental techniques, drugs, or devices in human subjects and appropriate informed consent documents were utilized.
Furthermore, I state that any and all animals used for experimental purposes received humane care in USDA registered facilities in compliance with the “Principles of Laboratory Animal Care” formulated by the National Society for Medical Research and the “Guide for the Care and Use of Laboratory Animals” prepared by the Institute of Laboratory Animal Resources and published by the National Institutes of Health (NIH Publication No. 85-23, revised 1985).