Relapsed chronic lymphocytic leukemia with a cardiac mass: A case report

Area of Science:

• Hematology
• Oncology
• Cardiology

Background:

• Chronic lymphocytic leukemia (CLL) is the most common hematological malignancy in the USA.
• Extramedullary disease in CLL is rare and poorly understood.
• Clinically significant cardiac or pericardial involvement by CLL is exceptionally uncommon, with limited case reports.

Observation:

• A 51-year-old male with a history of CLL in remission presented with symptoms including fatigue, dyspnea, night sweats, and lymphadenopathy.
• Imaging revealed a large soft tissue mass in the right atrium and ventricle, with suspected pericardial involvement and enlarged lymph nodes.
• Cardiac imaging confirmed a substantial infiltrating mass extending into the inferior vena cava and coronary sinus.

Findings:

• Histopathology of a lymph node biopsy confirmed Small Lymphocytic Lymphoma (SLL)/CLL.
• This case represents one of the few documented instances of cardiac extramedullary-CLL presenting as an isolated cardiac mass.
• The findings underscore the potential for rare presentations of CLL.

Implications:

• This case highlights the importance of considering rare extramedullary manifestations of CLL, even in patients with previously treated disease.
• Further research is necessary to elucidate the disease course, prognosis, and optimal management strategies for cardiac extramedullary CLL.
• The role of surgical intervention in such cases requires further investigation.