Cardiac Involvement in a Lymphoma: A Rare Extranodal Site

Cardiac involvement in lymphoma is rare and usually presents as a late manifestation of the disease. Although clinically asymptomatic and mostly found on autopsy, some patients may present with ventricular outflow obstruction, valve dysfunction, arrhythmias, pericardial effusion, cardiac tamponade, and tumor embolization. Multimodality imaging is important in distinguishing cardiac masses to provide optimal treatment. Here, we describe the case of a 54-year-old woman who presented with dyspnea on exertion and hemodynamic compromise. With the aid of multimodality imaging, the patient was found to have a right atrial cardiac mass. Given her worsening symptoms and hemodynamic instability, the patient underwent excision of the right atrial mass. Ultimately, histopathology revealed diffuse large B-cell lymphoma. The patient was evaluated further and completed systemic therapy without any adverse events and achieved complete metabolic response (Deauville score 1). The patient completed her first-year follow-up, and an annual positron emission tomography-computed tomography showed no evidence of disease.