Primary cardiac burkitt lymphoma presenting with abdominal pain.

Dimitrios Tzachanis,Rajan Dewar,Katarina Luptakova,James D Chang,Robin M Joyce

doi:10.1155/2014/687598

Abstract

We describe the case of a 44-year-old woman with primary Burkitt lymphoma of the heart who presented with abdominal bloating and epigastric discomfort secondary to tamponade physiology caused by a large pericardial effusion. The pericardial fluid contained a large number of highly atypical lymphocytes with moderate basophilic cytoplasm, rare punched-out vacuoles, a vesicular nuclear chromatin, large nucleolus, and marginated chromatin that by FISH were positive for the 8;14 translocation. She had no other sites of disease. She was treated with four alternating cycles of modified CODOX-M and IVAC in combination with rituximab and remains in remission more than 5 years since diagnosis.

Highlights

Lymphomas are diagnosed in about 1-2% of patients with a primary cardiac tumor and occur more frequently in immunosuppressed hosts such as in patients infected with the human immunodeficiency virus (HIV) [4]
Lymphomas are the second most common tumors involving the heart in HIV infected patients reflecting the higher incidence of lymphoma and of extranodal involvement in patients with HIV [5]
FISH for t(8;14) is virtually confirmatory of Burkitt lymphoma (BL). For staging she underwent a bone marrow biopsy that was negative for lymphomatous involvement and a CT of the torso that showed a decreased, small pericardial effusion, stable small bilateral pleural effusions, a 2.6 cm lobulated soft-tissue lesion in the right atrium, and no evidence of lymphadenopathy

Summary

Background

Primary malignant cardiac tumors are 100–1000 times less common than metastatic disease to the heart. Lymphomas are diagnosed in about 1-2% of patients with a primary cardiac tumor and occur more frequently in immunosuppressed hosts such as in patients infected with the human immunodeficiency virus (HIV) [4]. Diffuse large B cell lymphoma is the most common histologic type of cardiac lymphoma. Kuroda et al reported the case of a 79-year-old female with cardiac BL in the form of a left ventricular mass and a massive pericardial effusion. Stefani et al published the case of a 61-year-old woman with BL who presented with a large mass arising from the right ventricle and with associated pericardial and pleural effusions [8]. Chalabreysse et al in 2002 described a case of primary BL as part of their review of the only 35 cases of primary cardiac

RV LV

Findings

Discussion