Second primary cardiac B-cell lymphoma after radiation therapy and chemotherapy--a case report

A 76-year-old man was found to have esophageal squamous cell carcinoma and had been treated with radiational therapy and chemotherapy. Five years later, he was readmitted with dyspnea and marked edema of his extremities and face. An echocardiographic examination revealed a mass lesion in the pericardium with pericardial effusion behind the left ventricular posterior wall, which was near the site of the original esophageal cancer. Coronary arteriography revealed a feeder artery to the mass from the left circumflex branch. No findings indicated a recurrence of the esophageal cancer; cytologic studies showed malignant lymphoma cells of B-cell origin. A second primary cancer of some organs including blood cells might be induced by the carcinogenic effects of ionizing radiation or chemotherapeutic agents. This is the first case of second primary cardiac B-cell lymphoma after combination therapy.