Primary cardiac lymphoma include those
lymphomas
originating first
in the heart (excluding those involving heart as part of
disseminating lymphoma).
Primary cardiac
lymphoma is extremely rare in immunocompetent patients. It is usually
seen in immunocompromised patients, particularly in association
with the acquired immunodeficiency syndrome. They are all
high-grade B-cell lymphomas.
Age:
The mean age
at presentation is approximately 60 years.
Clinical
presentation:
Patients may
present with dyspnea, congestive heart failure, chest pain,
epigastric pain, pericardial tamponade, conduction
abnormalities, or arrhythmia. Acute myocardial infarction
may be simulated by diffuse myocardial infiltration.
Site:
Primary
cardiac lymphoma typically involves the right atrium ,as
a mass and is often associated with pericardial effusion.
Involvement of the other chambers is less common. Most
patients have pericardial involvement, but extension into
the valves is rare.
Gross Image (AFIP)
REPORTING OF CARDIAC TUMOURS
Type
of Primary cardiac lymphomas :
Non
Hodgkin's Type
: (mostly of B-cell nature) -
Low ; Intermediate ; High grade
Microscopic diagnosis is based on the same criteria as applied in
lymphomas in general.
Image Link1(NEJM)
;
Image Link2(AFIP)
.
Cardiac lymphomas
demonstrate a wide range of histologic types, including
well-differentiated B-cell lymphomas, follicular center
cell lymphomas, diffuse large cell lymphomas, and
undifferentiated Burkitt-like lymphomas. The tumour usually infiltrate
the surrounding muscle and epicardial fat . In some cases
it may infiltrate the adventitia of the coronary arteries.
REPORTING OF ENDOMYOCARDIAL BIOPSY
Diagnosis of
lymphoma after cardiac transplantation should be done carefully, as
there are varieties of bizarre lymphocytic proliferations, which may be due
to viral infection.
ENDOMYOCARDIAL BIOPSY REPORTING-(ALLOGRAFT
REJECTION)
Prognosis is poor and treatment should
be as for other aggressive lymphomas.
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