A case report of primary cardiac lymphoma

Introduction. Primary cardiac lymphoma is an extremely rare malignant neoplasm. Diagnosis is often delayed because clinical manifestations are nonspecific and, in most cases, appear only at the terminal stage of the disease. Aim. To present a clinical case of primary cardiac lymphoma. Materials and methods. A concise literature review of cardiac lymphomas is provided, followed by a clinical case from the authors’ practice. Results. The disease had a prolonged course, initially masquerading as ischemic heart disease. Due to arrhythmias, the patient underwent a cardiac ultrasound examination, which first revealed a tumor in the right heart chambers. During surgery, a tumor of the right ventricle infiltrating the right atrium was confirmed; however, given the extent of the lesion, the case was deemed incurable. Histological and immunohistochemical (IHC) analyses established the diagnosis of diffuse large B-cell lymphoma of the heart, which was subsequently confirmed on autopsy. Conclusion. In this scenario, primary cardiac lymphoma mimicked ischemic heart disease and arrhythmias. Echocardiography in such patients allows for early suspicion of a cardiac tumor. A definitive diagnosis can only be made following histological and immunohistochemical examination of biopsy or surgical material.