Abstract
Cardiac involvement can occur in lymphoma, with the right heart being predominantlyaffected. The prognosis for patients with cardiac involvement is poor. A 28-year-old man,with a 4-year history of Hodgkin’s lymphoma, presented with progressive shortnessof breath and ascites. Chest X-ray (CXR) and CT scan revealed multiple masses in themediastinum. To exclude a pulmonary embolism, the patient underwent CT angiography,which incidentally revealed a filling defect in the right atrium. Trans-esophagealechocardiography confirmed the presence of a mass in the right atrium. Surgery wasperformed to obtain samples of the mediastinal masses and the right atrium mass.Pathological results indicated that the nature of the right atrium mass was diffuse largeB-cell lymphoma (DLBCL), suggesting that the Hodgkin’s lymphoma had transformedinto DLBCL. The transformation of Hodgkin’s lymphoma to DLBCL can occur, and cardiacinvolvement is not common. Given that the transformation of Hodgkin’s lymphoma intoDLBCL can occur many years after the initial diagnosis, the authors recommend followup of these patients, as the prognosis may be worse than for non-transformed subtypes.
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