Pericardial Diffuse Large B-Cell Lymphoma Diagnosed Via Computed Tomography-Guided Biopsy.

BACKGROUND

Primary pericardial lymphomas are rare. We describe a case of pericardial diffuse large B-cell lymphoma (DLBCL) diagnosed via computed tomography (CT)-guided biopsy.

CASE SUMMARY: A 57-year-old man presented with chest pain and weight loss for 1 month. Multiple diagnostic modalities revealed a pericardial mass with effusion. Pericardiocentesis was performed, and cytology suggested malignant lymphoma; however, the procedure was complicated by pneumothorax owing to mediastinal distortion from the pectus excavatum and minimal effusion. After multidisciplinary discussion, CT-guided biopsy was performed, which confirmed DLBCL. Polatuzumab vedotin, rituximab/cyclophosphamide, doxorubicin, and prednisone were initiated, resulting in tumor shrinkage.

DISCUSSION: Early histopathological diagnosis is essential for treating malignant lymphoma. In this case, CT-guided biopsy was selected as the safest and most effective approach and was successfully performed without complications.

TAKE-HOME MESSAGES: A multidisciplinary approach is necessary for early diagnosis of pericardial lymphoma. CT-guided biopsy can be effective in certain cases.