Cytomorphologic diagnosis of malignant lymphoma arising in the heart: a case report.
BACKGROUND
Primary malignant lymphoma of the heart is extremely rare. Because its clinical signs and symptoms are typically nonspecific, it is often very difficult to detect cardiac involvement while the patient is alive. We describe a case of malignant lymphoma involving predominantly the heart and pericardium and diagnosed by pericardiac effusion cytology antemortem.


METHODS
An 83-year-old woman presented with dyspnea on exertion. Echocardiography revealed a low-echoic tumor mass close to the right ventricular wall and massive pericardiac effusion. Diagnosis of diffuse large B-cell lymphoma was made by cytomorphologic examination and flow cytometry of the tumor cells obtained from the effusion. Although chemotherapy was instituted immediately, the patient died of progressive heart failure. Diffuse large B-cell lymphoma predominantly involving the intracardiovascular region was confirmed at autopsy.


CONCLUSIONS
From the experience in this case, we conclude that cytopathologic examination of sonographically guided aspiration of the cardiovascular region is very useful for antemortem diagnosis of primary malignant lymphoma of the heart.
Saito
T
T
Department of Pathology, Narita Red Cross Hospital, Chiba, Japan.
Tamaru
J
J
Kayao
J
J
Kuzuu
Y
Y
Wakita
H
H
Mikata
A
A
D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D014408:Biomarkers, Tumor / Q000032:analysis; D003520:Cyclophosphamide / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D004359:Drug Therapy, Combination; D004452:Echocardiography; D017809:Fatal Outcome; D005260:Female; D005434:Flow Cytometry; D006333:Heart Failure / Q000209:etiology / Q000473:pathology; D006338:Heart Neoplasms / Q000737:chemistry / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000188:drug therapy; D006801:Humans; D016130:Immunophenotyping; D016393:Lymphoma, B-Cell / Q000737:chemistry / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000188:drug therapy; D016403:Lymphoma, Large B-Cell, Diffuse / Q000737:chemistry / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000188:drug therapy; D010490:Pericardial Effusion / Q000175:diagnosis; D011241:Prednisone / Q000008:administration & dosage; D014750:Vincristine / Q000008:administration & dosage
D014408:Biomarkers, Tumor; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone