Primary Cardiac Lymphoma Presenting With Chest Pain.

BACKGROUND

Right ventricular (RV) masses are rare and remain asymptomatic until they enlarge and cause hemodynamic instability, arrhythmias, or pericardial effusion. Echocardiography, computed tomography, and cardiac magnetic resonance imaging provide important information about the location and characteristics of masses.

CASE SUMMARY: An 81-year-old man presented with chest pain and dizziness, with elevated biomarkers, and he was found to have a large RV intracardiac mass and pulmonary emboli. Subsequent cardiac biopsy revealed diffuse large B-cell lymphoma (DLBCL). The patient completed 6 cycles of chemotherapy, with complete remission at 4 months.

DISCUSSION: DLBCL is a rare cause of primary cardiac tumor. Multimodality imaging and prompt pathologic assessment are critical in determining the etiology of the mass and appropriately guiding therapy.

TAKE-HOME MESSAGES: RV masses require a broad differential diagnosis, including benign and malignant tumors. Multimodality imaging and cardiac biopsy are essential for making the diagnosis of DLBCL, which can respond quickly to medical treatment without surgical intervention.