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[Malignant lymphoma diagnosed by the pericardial biopsy]
Y Hashimoto1, H Fujita, R Sugamura
1First Department of Internal Medicine, School of Medicine, Yokohama City University.
Insights
Malignant lymphoma affecting the heart presented as heart failure and heart block. Gallium scans and pericardial biopsy aided in diagnosing this rare cardiac lymphoma case.
Area of Science:
- Cardiology
- Oncology
- Diagnostic Imaging
Background:
- Malignant lymphoma involving the pericardium is a rare condition.
- Cardiac lymphoma can present with diverse and severe cardiovascular symptoms.
Observation:
- A 69-year-old male presented with heart failure and complete heart block.
- Imaging revealed significant left pleural effusion and pericardial fluid.
- Gallium isotope study showed increased uptake in the heart.
Findings:
- Pericardial biopsy confirmed malignant lymphoma.
- Chemotherapy led to decreased pleural effusion and normalized gallium uptake.
- The case highlights diagnostic challenges of antemortem cardiac lymphoma.
Implications:
- Gallium isotope study is a valuable tool for diagnosing cardiac lymphoma.
- Pericardial biopsy is crucial for definitive diagnosis.
- Early diagnosis and treatment can improve outcomes for cardiac lymphoma.
Abstract:
The biopsy findings of malignant lymphoma involving the pericardium in a 69-year-old male were reported. The initial presenting symptoms were heart failure followed by rapidly progressive complete heart block. Pacemaker was inserted. Chest roentgenogram showed a marked left pleural effusion. An echocardiogram demonstrated pericardial fluid. The diagnosis of lymphoma was suggested by gallium isotope study with markedly increased isotope uptake in heart, and was subsequently confirmed by pericardial biopsy. After chemotherapy the pleural effusion was decreased and the uptake of gallium disappeared. While the diagnosis of cardiac involved lymphoma was hard antemortem, experience in this case suggests that gallium isotope study and pericardial biopsy are helpful in establishing the correct diagnosis.
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