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Primary cardiac lymphoma presenting with atrioventricular block.
Sung Woo Cho1, Yun Jeong Kang, Tae Hoon Kim
1Department of Internal Medicine, Sanggye-Paik Hospital, Inje University College of Medicine, Seoul, Korea.
Korean Circulation Journal
|February 26, 2010
Summary
Primary cardiac lymphoma (PCL) is rare and can cause heart rhythm problems. This case shows PCL presenting as atrioventricular block, successfully treated with chemotherapy, leading to complete remission.
Area of Science:
- Cardiology
- Oncology
- Pathology
Background:
- Primary cardiac lymphomas (PCL) are exceptionally rare cardiac tumors.
- Clinical presentations of PCL are diverse and depend on the tumor's location within the heart.
- Atrioventricular (AV) block is an uncommon manifestation of cardiac masses.
Purpose of the Study:
- To report a rare case of PCL presenting with progressive atrioventricular (AV) block.
- To highlight the diagnostic challenges and successful treatment of PCL.
- To emphasize the importance of considering PCL in patients with unexplained cardiac symptoms.
Main Methods:
- A 55-year-old male presented with chest discomfort, dyspnea, and night sweats.
- Electrocardiogram (ECG) revealed progressive atrioventricular (AV) block (first-degree to Mobitz type I).
- Cardiac computed tomography (CT) identified a large cardiac mass; biopsy confirmed diffuse large B-cell lymphoma. Treatment involved R-CHOP chemotherapy.
Main Results:
- The patient exhibited worsening chest discomfort and dyspnea correlating with ECG changes.
- Biopsy confirmed diffuse large B-cell lymphoma as the cause of the cardiac mass.
- Following R-CHOP chemotherapy, the patient achieved complete remission with normalization of ECG to sinus rhythm.
Conclusions:
- Primary cardiac lymphoma can manifest as atrioventricular block.
- Early diagnosis and multi-drug chemotherapy (R-CHOP) can lead to successful outcomes in PCL.
- This case underscores the importance of a comprehensive diagnostic approach for cardiac masses presenting with conduction abnormalities.
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