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Pericardial Diffuse Large B-Cell Lymphoma Diagnosed Via Computed Tomography-Guided Biopsy
Toshiya Yoshida1, Midori Nanamatsu1, Shunichi Asano1
1Department of Cardiology, Yokohama Rosai Hospital, Yokohama, Japan.
Insights
A rare case of pericardial diffuse large B-cell lymphoma (DLBCL) was diagnosed using computed tomography (CT)-guided biopsy. This minimally invasive approach proved safe and effective for diagnosing primary pericardial lymphoma.
Area of Science:
- Oncology
- Radiology
- Pathology
Background:
- Primary pericardial lymphomas are exceptionally rare conditions.
- Diffuse large B-cell lymphoma (DLBCL) can rarely manifest primarily in the pericardium.
Background:
Primary pericardial lymphomas are rare. We describe a case of pericardial diffuse large B-cell lymphoma (DLBCL) diagnosed via computed tomography (CT)-guided biopsy.
Case Summary:
A 57-year-old man presented with chest pain and weight loss for 1 month. Multiple diagnostic modalities revealed a pericardial mass with effusion. Pericardiocentesis was performed, and cytology suggested malignant lymphoma; however, the procedure was complicated by pneumothorax owing to mediastinal distortion from the pectus excavatum and minimal effusion. After multidisciplinary discussion, CT-guided biopsy was performed, which confirmed DLBCL. Polatuzumab vedotin, rituximab/cyclophosphamide, doxorubicin, and prednisone were initiated, resulting in tumor shrinkage.
Discussion:
Early histopathological diagnosis is essential for treating malignant lymphoma. In this case, CT-guided biopsy was selected as the safest and most effective approach and was successfully performed without complications.
Take-Home Messages:
A multidisciplinary approach is necessary for early diagnosis of pericardial lymphoma. CT-guided biopsy can be effective in certain cases.
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