1. Primary cardiac B cell lymphoma in an immunocompetent patient
- Author
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Kazumasa Harada, Joji Ishikawa, Rie Aoyama, and Masashi Miyawaki
- Subjects
Male ,medicine.medical_specialty ,Cyclophosphamide ,medicine.medical_treatment ,030204 cardiovascular system & hematology ,Gastroenterology ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,Pericarditis ,0302 clinical medicine ,hemic and lymphatic diseases ,Internal medicine ,Antineoplastic Combined Chemotherapy Protocols ,medicine ,Pericardium ,Humans ,B-cell lymphoma ,Chemotherapy ,business.industry ,Pericardial fluid ,General Medicine ,Middle Aged ,medicine.disease ,medicine.anatomical_structure ,Doxorubicin ,Vincristine ,Prednisolone ,Prednisone ,Rituximab ,Lymphoma, Large B-Cell, Diffuse ,business ,medicine.drug - Abstract
Primary cardiac lymphoma is a rare entity of extranodal lymphoma and is observed with increasing frequency in immunocompromised hosts. However, a considerable proportion of cardiac lymphomas still occur in immunocompetent patients. We report the case of a 55-year-old immunocompetent Japanese man with a large amount of pericardial fluid and the presentation of heart failure secondary to primary cardiac B cell lymphoma, which was diagnosed by cytological examination of pericardial fluid and imaging. The right atrium, right ventricle and pericardium were affected by the tumour, which encased the mid/distal portion of the right coronary artery (RCA). Pretreatment optical coherence tomography of the RCA demonstrated no tumour extension into the vascular structure but a focal mural thrombus. We initiated chemotherapy (steroid therapy then COP at half dose/R-CHOP/R-CHASE) [COP (C: Cyclophosphamide, O: Oncovin, P: Prednisolone) R-CHOP (R: Rituximab, C: Cyclophosphamide, H: Doxorubicin Hydrochloride, O: Oncovin, P: Prednisolone) R-CHASE (R: Rituximab, C: Cyclophosphamide, HA: high dose Cytarabine, S: Steroid, E: Etoposide)]with administration of low-dose aspirin to prevent possible ischaemic events. The patient had a good clinical course without adverse events except for transient pericarditis.
- Published
- 2023