Cardiac and breast diffuse large B-cell lymphoma with pericardial effusion and AV-block

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  • TOMIKAWA Tatsuki
    Department of Hematology, Saitama Medical Center, Saitama Medical University
  • TABAYASHI Takayuki
    Department of Hematology, Saitama Medical Center, Saitama Medical University
  • TOKUHIRA Michihide
    Department of Hematology, Saitama Medical Center, Saitama Medical University
  • WATANABE Reiko
    Department of Hematology, Saitama Medical Center, Saitama Medical University
  • SAGAWA Morihiko
    Department of Hematology, Saitama Medical Center, Saitama Medical University
  • NEMOTO Tomoe
    Department of Hematology, Saitama Medical Center, Saitama Medical University
  • KIMURA Yuta
    Department of Hematology, Saitama Medical Center, Saitama Medical University
  • TAKAHASHI Yasuyuki
    Department of Hematology, Saitama Medical Center, Saitama Medical University
  • MORI Shigehisa
    Department of Hematology, Saitama Medical Center, Saitama Medical University
  • HIGASHI Morihiro
    Department of Pathology, Saitama Medical Center, Saitama Medical University
  • TAMARU Jun-ichi
    Department of Pathology, Saitama Medical Center, Saitama Medical University
  • KIZAKI Masahiro
    Department of Hematology, Saitama Medical Center, Saitama Medical University

Bibliographic Information

Other Title
  • 心嚢水貯留と房室ブロックを伴った心臓および乳腺のびまん性大細胞型B細胞リンパ腫
  • 症例報告 心嚢水貯留と房室ブロックを伴った心臓および乳腺のびまん性大細胞型B細胞リンパ腫
  • ショウレイ ホウコク シンノウスイ チョリュウ ト ボウシツブロック オ トモナッタ シンゾウ オヨビ ニュウセンノビマンセイ ダイ サイボウガタ B サイボウ リンパシュ

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Abstract

Primary cardiac lymphoma is extremely rare and is associated with a poor prognosis. In most cases, cardiac involvement occurs as a late symptom and the diagnosis is thus delayed. We herein report a 35-year-old woman with cardiac diffuse large B-cell lymphoma (DLBCL) with breast infiltration. The patient was admitted to our hospital based on an initial presentation with dyspnea on exertion, chest pain, and a hard mass of the left breast. Echocardiography revealed a mass in the right atrium wall and interatrial septum, and massive pericardial effusion. ECG showed atrioventoricular block. We promptly performed a needle biopsy of the breast mass, which showed CD5-positive DLBCL, non-GCB type. The serum HIV reaction was negative. We thus diagnosed this patient as having cardiac and breast CD5-positive DLBCL, stage IVA, based on the massive pericardial effusion. The patient's prognosis was apparently poor. Therefore, she received 3 cycles of R-CHOP chemotherapy followed by autologous peripheral blood stem cell transplantation (PBSCT), resulting in a complete response. In general, cardiac lymphoma is associated with high mortality and has a poor prognosis. This case demonstrates that rapid and appropriate diagnosis, and immediate intensive chemotherapy followed by PBSCT might be necessary for the treatment of extranodal lymphoma indicative of a poor prognosis.

Journal

  • Rinsho Ketsueki

    Rinsho Ketsueki 56 (1), 9-15, 2015

    The Japanese Society of Hematology

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