Related Experiment Video
Updated: Dec 10, 2025
A Modified Cuff Technique for Mouse Cervical Heterotopic Heart Transplantation Model
Published on: February 7, 2022
Primary central nervous system lymphoma after heart transplantation: A case report and literature review
Insights
Primary central nervous system lymphoma (PCNSL) is exceptionally rare in heart transplant recipients. This case highlights the extremely poor prognosis and need for vigilance in transplant patients with neurological symptoms.
Area of Science:
- Oncology
- Transplantation Medicine
- Neurology
Background:
- Heart transplantation is a critical treatment for end-stage heart failure.
- Post-transplant lymphoproliferative disorder is a known complication, but primary central nervous system lymphoma (PCNSL) is exceedingly rare.
- Immunosuppressive therapy, such as tacrolimus, is standard post-transplant care.
Observation:
- A 53-year-old male developed neurological symptoms including dizziness, headache, and left-sided weakness 17 months post-heart transplant.
- Brain imaging revealed a large mass in the right temporal lobe, diagnosed as diffuse large B-cell lymphoma.
- Whole-body scans showed no other metastatic disease, confirming PCNSL.
Findings:
- The patient received whole-brain radiotherapy but experienced rapid disease progression.
- The patient died within two months of diagnosis, indicating a very poor prognosis.
- PCNSL in heart transplant recipients presents a significant clinical challenge.
Implications:
- Neurological symptoms in heart transplant recipients warrant thorough investigation for rare malignancies like PCNSL.
- Treatment strategies must be individualized, considering patient status and tolerance.
- Close monitoring of heart transplant recipients for neurological changes is crucial.
Rationale:
The heart transplantation is the most important treatment for patients with end-stage severe heart disease who failed to conventional therapy. Post-transplant lymphoproliferative disorder is the second most common malignancy in heart transplant recipients. However, primary central nervous system lymphoma (PCNSL) after heart transplantation is an extremely rare condition.
Patients Concerns:
This report described a 53-year-old male who was diagnosed as PCNSL 17 months after heart transplantation.
Diagnoses:
The patient was admitted to the local hospital presenting with dizziness, headache, and reduced left-sided power and sensation for 1 week. He had a medical history of heart transplantation because of the dilated cardiomyopathy 17 months ago and had a 17-month history of immunosuppressive therapy with tacrolimus. A computed tomography scan of the brain revealed a bulky mass in the right temporal lobe. The emergency intracranial mass resection and cerebral decompression were performed in our hospital. The histopathology of the brain lesions showed diffuse large B-cell lymphoma. A further FDG positron emission tomography-computed tomography scan of the whole body showed no significantly increased metabolic activity in other regions. The final diagnosis of this patient was PCNSL after heart transplantation.
Interventions:
Given the poor health condition, with the patient's consent, the whole brain radiotherapy was performed with supportive care.
Outcomes:
The disease deteriorated rapidly during the period of receiving radiotherapy, and he died within 2 months from the diagnosis.
Lessons:
PCNSL after heart transplantation is an extremely rare phenomenon with extremely poor prognosis. We should pay close attention to the heart recipients, especially when the patients present with neurological symptoms and signs. The available treatment options for PCNS-post-transplant lymphoproliferative disorder include the reduction of immunosuppressive drugs, immune-chemotherapy, operation, radiotherapy. However, individual treatments for heart transplant recipients with PCNSL should be based on the performance status and tolerance to treatment, combined with the doctor's experience and supportive care.
Related Concept Videos
01:16Primary Lymphoid Organs
The red bone marrow is a soft, spongy tissue nestled in the interior of long bones such as the humerus and femur. It is the site...
01:15Secondary Lymphoid Organs
The spleen is a vital organ in the lymphatic system, nestled in the upper left side of the abdomen. It is composed of two primary regions: the red pulp and the white pulp, each having distinct functions. The red pulp performs a significant role in blood filtration. It efficiently purges the blood of old or damaged red blood cells and...
01:18Lymphoid Cells and Tissues
Lymphoid cells consist of various types of immune system cells. These include B and T lymphocytes, which are responsible for producing antibodies and killing infected cells, respectively. Dendritic cells act as messengers between the innate and adaptive...
01:24Tissue Transplantation
The Biology of Tissue Transplantation
The biology of tissue transplantation hinges on the Major Histocompatibility Complex (MHC) molecules. These molecules...