Related Experiment Videos
Primary cardiac lymphoma
C R Curtsinger1, M J Wilson, K Yoneda
1Department of Pathology, Veterans Administration Medical Center, Lexington, KY 40511.
Insights
A rare case of primary cardiac lymphoma in an 80-year-old man, involving the tricuspid valve, highlights the diagnostic challenges of this uncommon malignancy. Autopsy confirmed the diagnosis, revealing only 15 such cases meeting strict criteria.
Area of Science:
- Cardiology
- Oncology
- Pathology
Background:
- Primary cardiac lymphoma is a rare malignancy involving only the heart and pericardium, as defined in 1977.
- Many reported cases of cardiac lymphoma involve metastases, complicating the definition of primary cardiac lymphoma.
- Accurate diagnosis often requires autopsy, especially in cases with atypical presentations.
Observation:
- An 80-year-old male presented with left hemiparesis, rapidly progressing to right-sided heart failure and death.
- Echocardiography suggested a cardiac tumor, but the diagnosis of primary cardiac lymphoma was confirmed post-mortem.
- The autopsy revealed the lymphoma involved a tricuspid valve leaflet, a previously unreported site.
Findings:
- This case represents the 15th reported instance of primary malignant lymphoma of the heart meeting the established criteria.
- The tricuspid valve involvement is a novel finding in the literature for primary cardiac lymphoma.
- The study reviewed global literature to ascertain the true incidence of primary cardiac lymphoma.
Implications:
- This case underscores the importance of considering rare diagnoses in the differential of cardiac masses and heart failure.
- Improved diagnostic strategies may be needed to detect primary cardiac lymphoma earlier, potentially improving patient outcomes.
- Further research into the pathogenesis and clinical presentation of primary cardiac lymphoma is warranted.
Abstract:
An 80-year-old man who initially presented with a left hemiparesis rapidly developed right-sided heart failure and died. Although an echocardiogram suggested the presence of a tumor, the diagnosis of a primary cardiac lymphoma was made only at autopsy. The tumor involved a leaflet of the tricuspid valve, a finding not previously reported in the literature. In 1977, the Armed Forces Institute of Pathology defined a primary malignant lymphoma of the heart as that involving only the heart and pericardium. Many reports of primary cardiac malignant lymphomas have been published, however, most of which mention the presence of metastases. We have reviewed the world literature to determine the number of actual cases of primary malignant lymphoma of the heart. Only 15 reported cases, including the current case, were found to meet the current criteria.