Primary cardiac lymphoma causing right atrial occlusion

Area of Science:

• Cardiology
• Oncology
• Pathology

Background:

• Primary cardiac lymphomas (PCL) are exceptionally rare neoplasms.
• Diffuse large B-cell lymphoma (DLBCL) is an aggressive subtype with a poor prognosis.
• Cardiac tumors can mimic other cardiovascular conditions, delaying diagnosis.

Observation:

• A massive, lobulated tumor was identified, occluding the right atrium and infiltrating surrounding cardiac structures.
• The patient initially presented with symptoms suggestive of chronic right heart dysfunction.
• Despite surgical debulking and tricuspid annuloplasty, the patient experienced multi-organ failure.

Findings:

• Pathological analysis confirmed diffuse large B-cell lymphoma with a 100% proliferation rate.
• The tumor's size is among the largest reported for intra-cardiac PCL.
• Aggressive tumor growth occurred with surprisingly mild symptomatology until late stages.

Implications:

• This case underscores the importance of considering rare cardiac tumors in the differential diagnosis of heart dysfunction.
• The aggressive nature of intra-cardiac DLBCL necessitates prompt and comprehensive management strategies.
• Further research into early detection and novel therapeutic approaches for PCL is warranted.