Primary cardiac lymphoma is extremely rare in immunocompetent patients. It is usually seen in immuno compromised 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.
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 Link
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.
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.
Prognosis is poor and treatment should be as for other aggressive lymphomas.
STUDY: CARDIAC LYMPHOMAby
AKSHAYA SRIKANTH
Pharm.D Resident
India
