title: Primary Cardiac Lymphoma: Diagnosis and the Impact of Chemotherapy on Cardiac Structure and Function.
abstract: We report a case of primary cardiac lymphoma presenting as myopericarditis and rapidly deteriorating into biventricular heart failure and ventricular arrhythmias. Computed tomography and cardiac magnetic resonance (CMR) imaging showed extensive myocardial infiltration with typical patterns on tissue characterization CMR images, raising clinical suspicion. Diagnosis was confirmed by myocardial histologic examination. Marked regression of tumor burden was apparent after 6 cycles of anthracycline-based chemotherapy. This case illustrates that a high degree of suspicion for this rare entity is mandated to institute timely treatment. Rapid tumor lysis may induce life-threatening acute cardiac decompensation that requires intensive monitoring and support therapy.
authors.affiliation: Cardiovascular Magnetic Resonance Unit, Royal Brompton Hospital, London, United Kingdom.
authors.forename: Maude
authors.initials: M
authors.lastname: Pagé
authors.affiliation: Frimley Health NHS Foundation Trust, Frimley, United Kingdom.
authors.forename: Agata E
authors.initials: AE
authors.lastname: Grasso
authors.affiliation: Cardiovascular Magnetic Resonance Unit, Royal Brompton Hospital, London, United Kingdom.
authors.forename: John-Paul
authors.initials: JP
authors.lastname: Carpenter
authors.affiliation: Department of Cardiovascular Pathology, St. Georges Medical School, London, United Kingdom.
authors.forename: Mary N
authors.initials: MN
authors.lastname: Sheppard
authors.affiliation: Princess Royal University Hospital, Farnborough, United Kingdom.
authors.forename: Stefan P
authors.initials: SP
authors.lastname: Karwatowski
authors.affiliation: Cardiovascular Magnetic Resonance Unit, Royal Brompton Hospital, London, United Kingdom; National Heart and Lung Institute, Imperial College London, London, United Kingdom. Electronic address: r.mohiaddin@rbht.nhs.uk.
authors.forename: Raad H
authors.initials: RH
authors.lastname: Mohiaddin
mesh_terms: D058846:Antibodies, Monoclonal, Murine-Derived / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001145:Arrhythmias, Cardiac / Q000188:drug therapy / Q000209:etiology; D003520:Cyclophosphamide / Q000627:therapeutic use; D004317:Doxorubicin / Q000627:therapeutic use; D006333:Heart Failure / Q000188:drug therapy / Q000209:etiology; D006338:Heart Neoplasms / Q000188:drug therapy* / Q000473:pathology*; D006801:Humans; D016403:Lymphoma, Large B-Cell, Diffuse / Q000188:drug therapy* / Q000473:pathology*; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D008875:Middle Aged; D009205:Myocarditis / Q000188:drug therapy / Q000209:etiology; D010493:Pericarditis / Q000188:drug therapy / Q000209:etiology; D011241:Prednisone / Q000627:therapeutic use; D000069283:Rituximab; D014750:Vincristine / Q000627:therapeutic use
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; C571759:R-CHOP protocol; D000069283:Rituximab; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone