Korean J Hematol.  2010 Dec;45(4):282-285. 10.5045/kjh.2010.45.4.282.

Long-term disease-free survival of patients with primary cardiac lymphoma treated with systemic chemotherapy and radiotherapy

• Shin DY
• Lee YG
• Lee HJ
• Choi S
• Park JJ
• Kim DW

• KMID: 2252043
• DOI: http://doi.org/10.5045/kjh.2010.45.4.282

Abstract

Primary cardiac lymphoma (PCL) is a rare disease entity with only a few reported cases in Korea. In this paper, we report a case of PCL in a 59-year-old man presenting with chest pain. Diffuse large B-cell lymphoma was diagnosed through a cardiac catheterization-assisted percutaneous endomyocardial biopsy, and there was no evidence of extracardiac involvement of the lymphoma.The patient had a complete clinical response after systemic chemotherapy with a rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone (R-CHOP) regimen and additional post-chemotherapeutic radiation therapy. The patient experienced a long-term disease-free survival of over 4 years. However, he received coronary artery bypass graft surgery due to an acute myocardial infarction that occurred 3 years after the completion of the radiation therapy. Although the addition of radiation therapy to the treatment is thought to decrease the risk of relapse in patients with PCL, a careful and thorough consideration of the potential complications of radiation therapy, particularly with respect to cardiac complications, should be considered.

Keyword

Lymphoma; Myocardial infarction; Drug therapy; Radiotherapy

MeSH Terms

Antibodies, Monoclonal, Murine-Derived
Biopsy
Chest Pain
Coronary Artery Bypass
Cyclophosphamide
Disease-Free Survival
Doxorubicin
Humans
Korea
Lymphoma
Lymphoma, B-Cell
Middle Aged
Myocardial Infarction
Prednisolone
Rare Diseases
Recurrence
Transplants
Vincristine
Rituximab
Antibodies, Monoclonal, Murine-Derived
Cyclophosphamide
Doxorubicin
Prednisolone
Vincristine

Figure

• 

  Fig. 1 (A) T2-weighted MRI image showing a cardiac mass (arrow) with similar signal intensity compared to the myocardium, and which had invaded the pericardial space and the right atrial wall with an intracardiac extension. (B) Biopsy specimen showing large, atypical lymphoid cells with irregularly shaped nuclei containing clumped chromatin and prominent nucleoli (hematoxylin and eosin stain, ×400). (C) CD20 immunohistochemistry of a biopsy specimen showing diffuse membranous staining. (D) A magnetic resonance image performed after 6 cycles of R-CHOP showing a partial response of the cardiac mass (arrow).

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