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Updated: Sep 15, 2025
Enhancing Tumor Content through Tumor Macrodissection
Published on: February 12, 2022
Primary cardiac diffuse large B-cell lymphoma patient: clinical, histologic, immunophenotypic feature and a novel
Chenxi Ying1, Weidong Li1, Yu Zou1
1Department of Cardiovascular Surgery, The First Affiliated Hospital Zhejiang University of Medicine, 79 Qingchun Road, Shangcheng District, Hangzhou City, Zhejiang Province, China.
Insights
A rare cardiac lymphoma case used a novel surgical technique for tumor removal. While initially successful, the aggressive double expressor lymphoma showed disease progression at six months, highlighting treatment challenges.
Area of Science:
- Cardiology
- Oncology
- Surgical Innovation
Background:
- Primary cardiac lymphoma (PCL) is a rare tumor, with non-germinal center B-cell (non-GCB) diffuse large B-cell lymphoma (DLBCL) posing significant diagnostic and therapeutic challenges.
- Non-GCB DLBCL often causes severe symptoms due to cardiac involvement.
Observation:
- A 68-year-old woman presented with palpitations, dizziness, and obstructive cardiac symptoms.
- Imaging revealed a large right atrial mass near the superior vena cava.
- A novel "zongzi"-shaped endoscopic gauze folding technique was used for tumor resection.
Findings:
- Pathology confirmed double expressor DLBCL (BCL2 and MYC co-expression), indicating a high-risk profile.
- The patient had an uneventful postoperative recovery and was discharged in stable condition.
- Six-month follow-up revealed local disease progression.
Implications:
- Novel surgical techniques can aid in complete resection of cardiac tumors while preserving cardiac structure.
- Aggressive PCL subtypes, like double expressor lymphoma, require further research into optimized multimodal treatment approaches.
- This case highlights the ongoing challenges in managing primary cardiac DLBCL effectively.
Background:
Primary cardiac lymphoma (PCL) is a rare malignancy, representing a small fraction of primary cardiac tumors. Non-germinal center B-cell (non-GCB) diffuse large B-cell lymphoma (DLBCL), a subtype of PCL, often presents with severe symptoms due to its cardiac involvement, and poses diagnostic and therapeutic challenges. This case highlights the use of an innovative surgical approach in managing a non-GCB primary cardiac DLBCL.
Case Presentation:
We report the case of a 68-year-old woman presenting with palpitations, dizziness, and obstructive cardiac symptoms. Diagnostic imaging revealed a large mass in the right atrium near the superior vena cava. A novel "zongzi"-shaped endoscopic gauze folding technique was employed to facilitate complete tumor resection while preserving cardiac structure. Pathology confirmed double expressor DLBCL with BCL2 and MYC co-expression, indicating a high-risk profile. The patient's postoperative course was uneventful, and she was discharged in stable condition. However, follow-up imaging at six months revealed local disease progression.
Conclusions:
This case underscores the challenges in managing primary cardiac DLBCL and highlights the potential of novel surgical techniques to improve resection outcomes while minimizing structural damage to the heart. Further research is essential to optimize multimodal approaches, particularly for aggressive PCL subtypes like double expressor lymphoma.
