title: Primary cardiac lymphoma presenting as atrial flutter and total heart block.
abstract: Primary cardiac lymphoma is extremely rare. We present the case of a 70-year-old man with primary cardiac lymphoma involving interatrial septum, presenting as atrial flutter and total heart block. The diagnosis was obtained by echocardiography-guided transvenous endocardial biopsy which revealed diffuse large B-cell non-Hodgkin's lymphoma, CD 20+. After six courses of immunochemotherapy the patient achieved complete remission. After 2 months he developed a series of epileptic attacks. Intracerebral lymphoma extension was diagnosed. Two cycles of high-dose methotrexate and cranial irradiation were applied, resulting in a second complete remission.
authors.affiliation: Department of Internal Medicine, University Clinic of Cardiovascular Diseases, Clinical Medical Centre Rebro, Kispatićeva 12, 1000, Zagreb, Croatia. josko.bulum@zg.t-com.hr
authors.forename: Josko
authors.initials: J
authors.lastname: Bulum
authors.forename: Ljiljana
authors.initials: L
authors.lastname: Banfić
authors.forename: Maja
authors.initials: M
authors.lastname: Strozzi
authors.forename: Igor
authors.initials: I
authors.lastname: Aurer
authors.forename: Drazen
authors.initials: D
authors.lastname: Jelasić
mesh_terms: D000368:Aged; D001282:Atrial Flutter / Q000209:etiology*; D017548:Echocardiography, Transesophageal; D006327:Heart Block / Q000209:etiology*; D006338:Heart Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000628:therapy; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000628:therapy