Cardiac lymphoma is a rare tumor of the myocardium and/or pericardium. It may be considered as primary or secondary.
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Epidemiology
Primary cardiac lymphoma is a rare occurrence, representing only 10% of primary malignant cardiac tumors (1% of all primary cardiac tumors).
Secondary involvement of the heart by disseminated lymphoma (diffuse large B-cell) is more common than primary cardiac lymphoma, but is still a rare occurrence.
Both forms are much more common in patients with HIV/AIDS.
Clinical presentation
Cardiac lymphoma may present with dyspnea, edema, or arrhythmia. Pericardial effusion may give rise to tamponade.
Radiographic features
Ultrasound
Echocardiography
may detect an intracavitary mass or pericardial effusion
Cardiac CT
multiple circumscribed polypoid masses or an ill-defined infiltrative lesion
more common in right atrium
frequently associated with pericardial effusion
less likely to show necrosis than a cardiac sarcoma
heterogeneous contrast enhancement, isoattenuating or hypoattenuating relative to myocardium
MRI
atrial, particularly right atrial predominant location
variable signal intensity and contrast enhancement
Treatment and prognosis
Prognosis is poor with a median survival of 7 months after diagnosis.