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Updated: Aug 4, 2025
Flow Cytometry-Based Quantification and Analysis of Myocardial B-Cells
Published on: August 17, 2022
Case report: Complete atrio-ventricular block successfully reversed in newly diagnosed primary cardiac B-cell
Jiahui Mao1, Yitong Xu1,2, Mingfang Zhu1,2
1Department of Hematology, Qilu Hospital of Shandong University, Jinan, China.
Insights
Primary cardiac lymphoma (PCL) is rare, but early diagnosis via endomyocardial biopsy is crucial for better outcomes. This case highlights successful R-CDOP chemotherapy and pacemaker implantation for a patient with PCL and heart block.
Area of Science:
- Cardiology
- Oncology
- Pathology
Background:
- Primary cardiac lymphoma (PCL) is an exceptionally rare cardiac neoplasm.
- Delayed diagnosis of PCL is associated with poor prognosis.
- PCL can present with diverse cardiac symptoms, including atrioventricular block.
Observation:
- A 64-year-old male presented with dyspnea, palpitations, and third-degree atrioventricular block (AVB).
- Multimodality imaging and endomyocardial biopsy (EMB) confirmed primary cardiac B-cell lymphoma.
- The patient underwent chemotherapy with R-COP regimen and pacemaker implantation.
Findings:
- Successful treatment of third-degree AVB following R-COP chemotherapy and pacemaker implantation.
- Chemotherapy regimen was adjusted to R-CDOP, with aspirin and rosavastatin for secondary prevention.
- The patient achieved a good clinical course with a normal electrocardiogram post-treatment.
Implications:
- This case emphasizes the diagnostic importance of EMB for heart neoplasms.
- Endomyocardial biopsy is vital for timely diagnosis and management of PCL.
- Anthracycline-based chemotherapy is not contraindicated in primary cardiac lymphoma.
Abstract:
Primary cardiac tumors are extremely uncommon and primary cardiac lymphoma (PCL) is an even rarer subset. A definite diagnosis can be delayed, which increases the likelihood of a poor prognosis. We report a case involving a 64-year-old male who presented with dyspnea, palpitation, and third-degree atrioventricular block (AVB) secondary to primary cardiac B-cell lymphoma that was diagnosed via endomyocardial biopsy (EMB) and multimodality imaging. Chemotherapy was initiated using rituximab, cyclophosphamide, vindesine, and prednisone (R-COP) followed by implantation of an artificial capsule pacemaker. Third-degree AVB vanished, and the subsequent cycle of treatment was adjusted as R-CDOP (rituximab, cyclophosphamide, doxorubicin liposome, vindesine, and prednisone), with aspirin and rosavastatin to prevent ischemic events. So far, the patient had a good clinical course and normal electrocardiogram. This case underscores the importance of EMB in the diagnosis of heart neoplasms. It is worth noting that anthracycline is not contraindicated in PCL.
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