Primary cardiac lymphoma

Malignant lymphoma rarely involves the heart, and is diagnosed predominantly late in the course of illness or autopsy. Antemortem diagnosis and response to therapy have rarely been reported. We report on a case who presented with progressive exertional dyspnea, atrial fibrillation. Large atrial mass, pericardial effusion, and mediastinal adenopathy were seen on echocardiogram and computerized tomography. Diagnosis of diffuse large cell lymphoma was made on thoracotomy and biopsy. Systemic chemotherapy with M-BACOD resulted in complete resolution. The patient continues to be in remission 12 months after completion of therapy and 21 months after diagnosis.