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Primary myocardial diffuse large B cell lymphoma. Report of one case
Luis F Rubalcava Lara1, Alejandro Aviles-Salas2, Myrna Candelaria3
1Hematology Department, Instituto Nacional de Cancerología-México, Universidad Nacional Autónoma de México, Mexico City, Mexico.
Insights
Primary cardiac lymphoma is rare. This case study details a 65-year-old male with diffuse large B-cell lymphoma presenting as cardiac tamponade, unresponsive to R-CVP chemotherapy.
Area of Science:
- Cardiovascular Pathology
- Hematologic Oncology
- Oncology
Background:
- Diffuse Large B-Cell Lymphoma (DLBCL) rarely involves the heart.
- Primary cardiac lymphoma is an exceptionally uncommon diagnosis.
Observation:
- A 65-year-old male presented with acute cardiac tamponade.
- Diagnosis was confirmed via myocardial biopsy during pericardial window surgery.
- The patient exhibited resistance to standard R-CVP chemotherapy.
Findings:
- The myocardial biopsy revealed diffuse large B-cell lymphoma.
- Initial treatment with rituximab, cyclophosphamide, vincristine, and prednisone (R-CVP) showed no response.
- Palliative chemotherapy with gemcitabine and oxaliplatin was initiated.
Implications:
- This case highlights the diagnostic challenges of primary cardiac lymphoma.
- It underscores the need for considering rare cardiac manifestations in lymphoma patients.
- Treatment resistance necessitates exploring alternative palliative chemotherapy regimens.
Abstract:
Primary myocardial involvement of Diffuse Large B-Cell lymphoma is extremely rare, accounting for 0.5 % of all lymphomas. We report a 65-year-old male, presenting with an acute cardiac tamponade, which was drained. A pericardial window with myocardial biopsy was carried out, disclosing a diffuse large B cell lymphoma. He received 6 cycles of rituximab, cyclophosphamide, vincristine, and prednisone (R-CVP), without response. Finally, a palliative chemotherapy with gemcitabine plus oxaliplatin was prescribed.
