Primary Cardiac Lymphoma Presenting Clinically as Restrictive Cardiomyopathy

An unusual case of primary cardiac lymphoma presenting as restrictive cardiomyopathy with arrhythmia is reported in a 72-year-old woman who was admitted for evaluation of exertional dyspnea and palpitations. Electrocardiography (ECG) showed atrioventricular dissociation and right heart cardiac cathe...

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Bibliographic Details
Published in:Circulation Journal 2005, Vol.69(2), pp.249-252
Main Authors: Fujisaki, Joji, Tanaka, Takahiro, Kato, Jyundai, Saito, Tetsuya, Yano, Kohei, Shimizu, Yutaka, Sada, Toshikatsu, Kitazume, Kouichi, Fujita, Akira, Kira, Yuji
Format: Article
Language:English
Subjects:
Aged
Arrhythmia
Arrhythmias, Cardiac - etiology
Cardiac Catheterization
Cardiomyopathy, Restrictive - etiology
Diagnosis, Differential
Electrocardiography
Female
Heart Block
Heart Neoplasms - complications
Heart Neoplasms - diagnosis
Humans
Lymphoma, B-Cell - complications
Lymphoma, B-Cell - diagnosis
Lymphoma, Large B-Cell, Diffuse - complications
Lymphoma, Large B-Cell, Diffuse - diagnosis
Malignant lymphoma
Remission Induction - methods
Restrictive cardiomyopathy
Tomography, X-Ray Computed
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Summary:An unusual case of primary cardiac lymphoma presenting as restrictive cardiomyopathy with arrhythmia is reported in a 72-year-old woman who was admitted for evaluation of exertional dyspnea and palpitations. Electrocardiography (ECG) showed atrioventricular dissociation and right heart cardiac catheterization revealed a typical `dip-and-plateau' waveform. Restrictive cardiomyopathy was suspected because computed tomography (CT) did not reveal pericardial thickening, calcifications, or an effusion. Heart failure initially improved with diuretic therapy, but subsequently worsened, and the patient experienced a syncopal episode. ECG showed atrial fibrillation, and CT revealed a large mass in the right atrium and multiple tumors in the liver, which needle biopsy confirmed as diffuse large B-cell lymphoma. Chemotherapy induced complete remission, and her heart failure markedly improved. The `dip-and-plateau' waveform was no longer detected on repeat cardiac catheterization and the ECG showed restoration of sinus rhythm. Clinically, the diagnosis was primary cardiac lymphoma. (Circ J 2005; 69: 249 - 252)
ISSN:1346-9843
1347-4820
DOI:10.1253/circj.69.249