Cardiac involvement as first manifestation of peripheral T-cell not otherwise specified lymphoma

Cardiac involvement as the first manifestation of peripheral T-cell lymphoma not otherwise specified (PTCL-NOS) is extremely rare. We report on a 72-year-old man with hypertension, dyslipidaemia and prediabetes who presented with acute pleuropericarditis, pericardial effusion and conduction abnormalities. Despite initial treatment, his condition worsened. Imaging revealed pericardial/myocardial infiltration and a right atrial mass. Biopsy confirmed PTCL-NOS (CD3+, CD5+, CD7+, high Ki-67). Complications included ileus, pulmonary embolism and neutropaenia. CHOP failed; GemOx was ineffective; he died from hypernatremia. This reported case emphasises the aggressive course, diagnostic challenges and poor treatment response of cardiac PTCL-NOS.