CASE REPORT

Heart and Vessels

, Volume 22, Issue 1, pp 52-54

First online:

Primary cardiac lymphoma presenting as atrial flutter and total heart block

  • Joško BulumAffiliated withDepartment of Internal Medicine, University Clinic of Cardiovascular Diseases, Clinical Medical Centre Rebro Email author 
  • , Ljiljana BanfićAffiliated withDepartment of Internal Medicine, University Clinic of Cardiovascular Diseases, Clinical Medical Centre Rebro
  • , Maja StrozziAffiliated withDepartment of Internal Medicine, University Clinic of Cardiovascular Diseases, Clinical Medical Centre Rebro
  • , Igor AurerAffiliated withDivision of Hematology, University Clinic of Cardiovascular Diseases, Clinical Medical Centre Rebro
  • , Dražen JelašićAffiliated withDepartment of Pathology, University Clinic of Cardiovascular Diseases, Clinical Medical Centre Rebro

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Abstract

Primary cardiac lymphoma is extremely rare. We present the case of a 70-year-old man with primary cardiac lymphoma involving interatrial septum, presenting as atrial flutter and total heart block. The diagnosis was obtained by echocardiography-guided transvenous endocardial biopsy which revealed diffuse large B-cell non-Hodgkin's lymphoma, CD 20+. After six courses of immunochemotherapy the patient achieved complete remission. After 2 months he developed a series of epileptic attacks. Intracerebral lymphoma extension was diagnosed. Two cycles of high-dose methotrexate and cranial irradiation were applied, resulting in a second complete remission.

Key words

Non-Hodgkin's lymphoma Heart neoplasm Heart block Echocardiography Chemotherapy