Myocardial Invasion of Cardiac Lymphoma Assessed With Myocardial Strain Imaging

Abstract

In a 17-year-old man complaining of exertional chest pain, computed tomography and magnetic resonance imaging showed a mass originating from the right atrium invading the pulmonary artery compatible with malignant lymphoma. However, its invasion to the left ventricular myocardium was not evident. Conventional echocardiography only identified the thickened left ventricular posterior wall. However, transmural myocardial strain distribution obtained by myocardial strain imaging clearly demonstrated abnormal myocardium at the posterior wall suggesting myocardial invasion. The abnormal finding disappeared after chemotherapy. Assessment of transmural myocardial strain profile using myocardial strain imaging was useful to differentiate normal and abnormal myocardium, leading to a correct diagnosis of myocardial invasion.