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Published on: June 11, 2019
Echocardiographic Findings of Malignant Lymphoma with Cardiac Involvement: A Single-center Retrospective
Toshiaki Ebina1, Yuka Sano1, Michiko Hirabayashi1
1Department of Laboratory Medicine and Clinical Investigation, Yokohama City University Medical Center, Japan.
Insights
Cardiac involvement in malignant lymphoma (ML) is uncommon (1.5%), particularly in diffuse large B-cell lymphoma (DLBCL). Transthoracic echocardiography (TTE) is valuable for detecting cardiac issues and monitoring treatment response in ML patients.
Area of Science:
- Cardiology
- Oncology
- Medical Imaging
Background:
- Malignant lymphoma (ML) can affect any organ, making cardiac involvement challenging to diagnose without overt symptoms.
- Early detection of cardiac involvement in ML is crucial for patient management.
Purpose of the Study:
- To determine the incidence of cardiac involvement in ML patients.
- To identify transthoracic echocardiography (TTE) findings associated with cardiac involvement in ML.
Main Methods:
- Retrospective review of 453 ML patients from January 2013 to December 2019.
- Analysis of TTE data for 394 patients who underwent the procedure at diagnosis or during their clinical course.
- Evaluation of specific lymphoma subtypes, including diffuse large B-cell lymphoma (DLBCL).
Main Results:
- Cardiac involvement was detected in 1.5% (6 out of 394) of ML patients who underwent TTE.
- Diffuse large B-cell lymphoma (DLBCL) was the most frequent type of ML with cardiac involvement.
- Pericardial effusion was observed in five patients; cardiac lesions varied, and left ventricular ejection fraction was preserved in most.
Conclusions:
- Cardiac involvement in ML is infrequent but occurs, with B-cell lymphomas, especially DLBCL, being commonly implicated.
- Transthoracic echocardiography (TTE) is an effective non-invasive tool for assessing cardiac involvement, treatment response, and cardiac function in ML patients.
- While pericardial effusion is a common finding, the spectrum of cardiac lesions in ML is diverse.
Abstract:
Objective Although malignant lymphoma (ML) can occur in every organ, diagnosing cardiac involvement without cardiac manifestations is difficult. We therefore investigated the incidence of cardiac involvement in ML in our hospital and clarified the transthoracic echocardiography (TTE) findings of cardiac involvement. Methods Patients with ML referred to our hospital between January 2013 and December 2019 were retrospectively reviewed. Patients During the study period, 453 patients were identified. The mean age was 64.9 years old, and 54% of the patients were men. Results Diffuse large B-cell lymphoma (DLBCL) was the most common lymphoma, followed by follicular lymphoma. Of the 453 patients, 394 (87.0%) underwent TTE at the initial diagnosis or during the clinical course. The performance rates of TTE in DLBCL, Hodgkin lymphoma, and mantle cell lymphoma were above 90%. Cardiac involvement was detected in 6 (five with DLBCL and one with B-cell lymphoma) (1.5%) of the 394 patients who underwent TTE. The involved lesions of the heart varied, and five patients had pericardial effusion. Five patients had a preserved left ventricular ejection fraction. All patients were treated with chemotherapy, and some were treated with radiation and surgery. Conclusion Cardiac involvement was observed in six (1.5%) of the patients with ML who underwent TTE. B-cell lymphoma, especially DLBCL, is a common ML with cardiac involvement. Although five patients had pericardial effusion, the involved lesions of the heart were not uniform. TTE is a useful imaging modality to noninvasively and repeatedly evaluate the tumor characteristics, response to ML treatment, and cardiac function.
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