Cardiac Path Online

Pathology of Cardiac Lymphoma

Dr Sampurna Roy MD

 

                                                                                                                      

 

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.

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.  

Case Link (NEJM) 

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.

 

 

Further reading:

AIDS-Associated Cardiac LymphomaA Review

Primary Cardiac Lymphoma: Diagnosis by Transjugular Biopsy

Primary Cardiac Lymphoma

Hodgkin's lymphoma presenting with heart failure

Cardiac Involvement with Lymphoma: A Review of the Literature

Non-Hodgkin's Lymphoma Involving the Heart

Primary Cardiac Lymphoma - Circulation

Cardiac malignant lymphoma in acquired immune deficiency syndrome.

De novo CD5-positive primary cardiac diffuse large B-cell lymphoma diagnosed by pleural fluid cytology.

Primary cardiac lymphoma presenting as an atypical type of hypertrophic cardiomyopathy.


 

 

Dr Sampurna Roy  MD

Consultant  Histopathologist (Kolkata - India)


 

 

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