Cardiac lymphoma

Last revised by Daniel J Bell on 14 Feb 2018

Cardiac lymphoma is a rare tumor of the myocardium and/or pericardium. It may be considered as primary or secondary.

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.

Cardiac lymphoma may present with dyspnea, edema, or arrhythmia. Pericardial effusion may give rise to tamponade.

  • 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
  • atrial, particularly right atrial predominant location
  • variable signal intensity and contrast enhancement

Prognosis is poor with a median survival of 7 months after diagnosis.

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