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Constrictive pericarditis secondary to underlying pericardial lymphoma
Ateeb Mahmood Khan1, Umair Javed1, Fateh Ali Tipoo Sultan2
1Section of Cardiology, Department of Medicine, The Aga Khan University Hospital, Karachi, Pakistan.
BMJ Case Reports
|November 23, 2025
Summary
A woman with constrictive pericarditis was diagnosed with high-grade B-cell lymphoma after surgery was abandoned. This rare presentation highlights the importance of considering lymphoma in pericardial disease.
Area of Science:
- Cardiology
- Oncology
- Pathology
Background:
- Constrictive pericarditis is a serious cardiac condition often requiring surgical intervention.
- Malignant causes of pericardial disease, such as lymphoma, can mimic inflammatory or infectious etiologies.
Purpose of the Study:
- To report a rare case of high-grade B-cell lymphoma presenting as constrictive pericarditis.
- To discuss the diagnostic challenges and management of non-Hodgkin lymphoma involving the pericardium.
Main Methods:
- Clinical presentation of fever, cough, dyspnea, and weight loss.
- Transthoracic echocardiography and cardiac MRI revealing pericardial effusion and thickening.
- Pericardiectomy attempt with subsequent pericardial biopsies for histopathological analysis.
Main Results:
- Imaging findings were consistent with constrictive pericarditis.
- Surgical attempt revealed densely adherent and vascular pericardium, leading to abandonment.
- Pericardial biopsies confirmed high-grade B-cell lymphoma.
Conclusions:
- High-grade B-cell lymphoma can present insidiously with symptoms mimicking constrictive pericarditis.
- Aggressive pericardial disease warrants thorough histopathological investigation, including biopsy, to rule out malignancy.
- This case underscores the importance of considering lymphoma in the differential diagnosis of unexplained pericardial effusions and thickening.
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