Epstein-Barr virus-associated diffuse large B-cell lymphoma arising on cardiac prostheses

Area of Science:

• Cardiovascular Pathology
• Hematologic Oncology
• Prosthetic Device Infections

Background:

• Primary cardiac lymphoma is exceptionally rare.
• Lymphoma associated with prosthetic heart valves is exceedingly uncommon, with only 3 prior case reports.
• Diffuse large B-cell lymphoma (DLBCL) can involve cardiac prosthetics.

Observation:

• Three patients presented with DLBCL involving prosthetic heart valves and a synthetic tube graft.
• Histological examination revealed tumor lymphocytes on the luminal surface of prosthetic materials with fibrinous debris.
• All cases exhibited a nongerminal center B-cell phenotype and were Epstein-Barr virus positive.

Findings:

• The described cases align with the 2008 World Health Organization criteria for DLBCL associated with chronic inflammation.
• No distant disease or recurrence was noted after surgical removal of the affected prostheses.
• The tumor lymphocytes demonstrated frequent mitoses and abundant karyorrhectic debris.

Implications:

• Surgical resectability of cardiac DLBCL in prosthetic devices may confer a more favorable prognosis compared to similar entities at other sites.
• This study expands the understanding of rare cardiac lymphomas.
• Further research is warranted to confirm the prognostic implications of resectability in cardiac DLBCL.