Primary Cardiac Lymphomas: Diagnosis and Management

Primary cardiac lymphomas (PCLs) are rare and often present a diagnostic challenge because of nonspecific clinical and imaging findings. Delayed diagnosis may lead to rapid clinical deterioration. We report a case series of 6 patients with PCL diagnosed between 2021 and 2025 at 2 tertiary cardio-oncology centers, illustrating the diagnostic pathway, therapeutic strategies, and clinical outcomes. Multimodality imaging was essential for initial evaluation, but histopathologic confirmation was required in all cases. Surgical biopsy proved to be a safe and effective method for tissue diagnosis. Systemic chemotherapy resulted in significant tumor regression or complete resolution in most patients, whereas surgical debulking was reserved for those with hemodynamic compromise. This case series highlights key diagnostic and management considerations that may assist clinicians facing suspected PCL.