2023 Volume 48 Issue 2 Pages 167-174
Over the past two decades at this hospital, five cardiac malignant lymphoma cases were encountered. All five cases were diagnosed as diffuse large B-cell lymphoma (DLBCL), and all of these cardiac tumors were initially detected by chest computed tomography. Moreover, solitary cardiac tumors were found in two cases. The tumor was located in the interventricular septum in one case and on the right atrium’s free wall side in four cases. In one of these four cases, the tumor was located on the whole right heart’s free wall, involving the posterior leaflet of the tricuspid valve. DLBCL was diagnosed by right ethmoid sinus tumor biopsy in one case, transthoracic echocardiography (TTE)-guided biopsy in two cases, intracardiac echocardiography (ICE)-guided biopsy in one case, and open chest biopsy due to technical difficulty with TTE- or ICE-guided biopsy in one case. TTE showed decreased tumor sizes due to chemotherapy in all cases. After the initial diagnosis, the patients succumbed between 7 months to 5.7 years (average 2.8 years) in four of the five cases, while in the remaining case; the patient has been alive for 10 years. Cardiac malignant lymphomas often shrink markedly due to chemotherapy, and patients with cardiac malignant lymphoma are expected to have a long-term prognosis. TTE is useful for cardiac malignant lymphoma detection and follow-up of its size after chemotherapy initiation. Biopsy for definitive diagnosis is necessary to start appropriate chemotherapy and echocardiography, including TTE and ICE, is useful for biopsy guidance.
