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An extranodal Richter's syndrome presenting with cardiac diffuse large B-cell lymphoma: a case report
Hua Wang1, Wei-Hong Yan1, Jun-Jie Sun2
1Department of Cardiology, Yantai Yuhuangding Hospital, Qingdao Medical College, Qingdao University, No. 20 East Yuhuangding Road, Yantai, 264000, China.
Background:
Richter's syndrome (RS) defines the transformation of chronic lymphocytic leukemia into high-grade lymphoma, which usually involves lymph nodes and bone marrow. Extranodal involvement of the heart is an extremely rare condition. Patients with heart involvement tended to have a low response to chemotherapy and relative poor prognosis. The transformation process of RS is often insidious and nonspecific making it challenging to diagnose.
Case Presentation:
A 64-year-old woman wih a history of chronic lymphocytic leukemia (CLL) presented with intermittent chest pain and was diagnosed with non-ST-elevation myocardial infarction (NSTEMI). However, the contrast enhanced echocardiography revealed a large irregular mass, measuring about 75.4 mm × 37.5 mm, located on the lateral and posterior wall of the right ventricle. Biopsy of the cardiac mass and the results revealed diffuse large B-cell lymphoma.
Conclusions:
We present a case of a 64-year-old woman with aggressive diffuse large B-cell lymphoma involving the heart. This case could provide some insights in the diagnosis of cardiac lymphoma.
