Skip to main content

Advertisement

SpringerLink
Log in

Imaging characteristics of cardiac dominant diffuse large B-cell lymphoma demonstrated with MDCT and PET/CT

  • Original Article
  • Published:
European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

To investigate the specific imaging findings of multidetector row CT (MDCT) and PET/CT with18F-FDG in cardiac dominant diffuse large B-cell lymphoma (DLBCL) in comparison with other cardiac tumours.

Methods

Five patients with DLBCL and 12 patients with other cardiac tumours including pericardial tumours were retrospectively reviewed. Among the patients with other cardiac tumours, seven had metastatic tumours, three had benign tumours, and two had other malignant cardiac tumours. The location of the cardiac mass, the encasement of the coronary artery surrounded by the mass, and pericardial effusion were evaluated using MDCT. The disease activity of the cardiac tumour was also evaluated by PET/CT.

Results

Four of the five DLBCL patients had primarily right-sided cardiac lesions, which was seen significantly more frequently in DLBCL than in other cardiac tumours (p = 0.028). All cardiac DLBCL lesions were located around the atrioventricular groove and encased the coronary arteries. ECG-gated cardiac MDCT showed that there was no apparent stenosis of the coronary arteries. Large amounts of pericardial effusion were seen in all DLBCL patients. PET/CT revealed significantly higher FDG uptake in DLBCL than in other cardiac malignant tumours, with no overlap (p = 0.0007).

Conclusion

The combination of a right-sided cardiac mass with a large pericardial effusion and no apparent stenosis of the encased coronary artery revealed by MDCT and a high maximum standard uptake value were the specific findings in cardiac dominant DLBCL.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Lymphoma Study Group of Japanese Pathologists. The world health organization classification of malignant lymphomas in japan: incidence of recently recognized entities. Pathol Int. 2000;50:696–702.

    Article  Google Scholar 

  2. Lee PW, Woo KS, Chow LT, Ng HK, Chan WW, Yu CM, et al. Images in cardiovascular medicine. Diffuse infiltration of lymphoma of the myocardium mimicking clinical hypertrophic cardiomyopathy. Circulation. 2006;113:e662–4.

    Article  PubMed  CAS  Google Scholar 

  3. O’Mahony D, Peikarz RL, Bandettini WP, Arai AE, Wilson WH, Bates SE. Cardiac involvement with lymphoma: a review of the literature. Clin Lymphoma Myeloma. 2008;8:249–52.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Petrich A, Cho SI, Billett H. Primary cardiac lymphoma: an analysis of presentation, treatment, and outcome patterns. Cancer. 2011;117:581–9.

    Article  PubMed  Google Scholar 

  5. Hsueh SC, Chung MT, Fang R, Hsiung MC, Young MS, Lu HF. Primary cardiac lymphoma. J Chin Med Assoc. 2006;69:169–74.

    Article  PubMed  Google Scholar 

  6. Kamiya K, Sakakibara M, Yamada S, Tan M, Furihata T, Kubota K, et al. Diffuse large B-cell lymphoma diagnosed by intracardiac echocardiography-guided cardiac tumor biopsy. Intern Med. 2012;51:1043–7.

    PubMed  Google Scholar 

  7. Cooper LT, Baughman KL, Feldman AM, Frustaci A, Jessup M, Kuhl U, et al. The role of endomyocardial biopsy in the management of cardiovascular disease: a scientific statement from the American Heart Association, the American College of Cardiology, and the European Society of Cardiology. Endorsed by the Heart Failure Society of America and the Heart Failure Association of the European Society of Cardiology. J Am Coll Cardiol. 2007;50:1914–31.

    Article  PubMed  Google Scholar 

  8. Hartman DS, David Jr CJ, Goldman SM, Friedman AC, Fritzsche P. Renal lymphoma: radiologic-pathologic correlation of 21 cases. Radiology. 1982;144:759–66.

    PubMed  CAS  Google Scholar 

  9. Wagner JR, Honig SC, Siroky MB. Non-Hodgkin’s lymphoma can mimic renal adenocarcinoma with inferior vena caval involvement. Urology. 1993;42:720–3. discussion 723–724.

    Article  PubMed  CAS  Google Scholar 

  10. Ngeow JY, Quek RH, Ng DC, Hee SW, Tao M, Lim LC, et al. High SUV uptake on FDG-PET/CT predicts for an aggressive B-cell lymphoma in a prospective study of primary FDG-PET/CT staging in lymphoma. Ann Oncol. 2009;20:1543–7.

    Article  PubMed  CAS  Google Scholar 

  11. Schoder H, Noy A, Gonen M, Weng L, Green D, Erdi YE, et al. Intensity of 18fluorodeoxyglucose uptake in positron emission tomography distinguishes between indolent and aggressive non-Hodgkin’s lymphoma. J Clin Oncol. 2005;23:4643–51.

    Article  PubMed  Google Scholar 

  12. Shao D, Wang SX, Liang CH, Gao Q. Differentiation of malignant from benign heart and pericardial lesions using positron emission tomography and computed tomography. J Nucl Cardiol. 2011;18:668–77.

    Article  PubMed  Google Scholar 

  13. Rahbar K, Seifarth H, Schafers M, Stegger L, Hoffmeier A, Spieker T, et al. Differentiation of malignant and benign cardiac tumors using 18F-FDG PET/CT. J Nucl Med. 2012;53:856–63.

    Article  PubMed  CAS  Google Scholar 

  14. Cheson BD, Pfistner B, Juweid ME, Gascoyne RD, Specht L, Horning SJ, et al. Revised response criteria for malignant lymphoma. J Clin Oncol. 2007;25:579–86.

    Article  PubMed  Google Scholar 

  15. Nand S, Mullen GM, Lonchyna VA, Moncada R. Primary lymphoma of the heart. Prolonged survival with early systemic therapy in a patient. Cancer. 1991;68:2289–92.

    Article  PubMed  CAS  Google Scholar 

  16. Kuo WH, Wu YC, Wu CY, Ho KC, Chiu PH, Wang CW, et al. Node/aorta and node/liver SUV ratios from (18)F-FDG PET/CT may improve the detection of occult mediastinal lymph node metastases in patients with non-small cell lung carcinoma. Acad Radiol. 2012;19:685–92.

    Article  PubMed  Google Scholar 

  17. Lee JC, Platts DG, Huang YT, Slaughter RE. Positron emission tomography combined with computed tomography as an integral component in evaluation of primary cardiac lymphoma. Clin Cardiol. 2010;33:E106–8.

    Article  PubMed  Google Scholar 

  18. Minamimoto R, Morooka M, Kubota K, Ito K, Masuda-Miyata Y, Mitsumoto T, et al. Value of FDG-PET/CT using unfractionated heparin for managing primary cardiac lymphoma and several key findings. J Nucl Cardiol. 2011;18:516–20.

    Article  PubMed  Google Scholar 

  19. Trifunovic D, Vujisic-Tesic B, Vuckovic M, Ostojic M, Ristic A, Bogdanovic A, et al. Multimodality imaging in the assessment of cardiac lymphoma presented as new-onset atrial fibrillation. Echocardiography. 2010;27:332–6.

    Article  PubMed  Google Scholar 

  20. Su HY, Huang HL, Sun CM, Hou SM, Chen ML. Primary cardiac lymphoma evaluated with integration of PET/CT and contrast-enhanced CT. Clin Nucl Med. 2009;34:298–301.

    Article  PubMed  Google Scholar 

  21. Cho JM, Sohn IS, Yang YJ. Heart in the heart: dual faced primary cardiac lymphoma on PET-CT. Int J Cardiol. 2010;142:e40–1.

    Article  PubMed  Google Scholar 

  22. Ohira H, Tsujino I, Yoshinaga K. (18)F-Fluoro-2-deoxyglucose positron emission tomography in cardiac sarcoidosis. Eur J Nucl Med Mol Imaging. 2011;38:1773–83.

    Article  PubMed  CAS  Google Scholar 

  23. Hoey E, Ganeshan A, Nader K, Randhawa K, Watkin R. Cardiac neoplasms and pseudotumors: imaging findings on multidetector CT angiography. Diagn Interv Radiol. 2012;18:67–77.

    PubMed  Google Scholar 

  24. Shah RN, Simmons TW, Carr JJ, Entrikin DW. Primary cardiac lymphoma diagnosed by multiphase-gated cardiac CT and CT-guided percutaneous trans-sternal biopsy. J Cardiovasc Comput Tomogr. 2012;6:137–9.

    Article  PubMed  Google Scholar 

  25. Chim CS, Chan AC, Kwong YL, Liang R. Primary cardiac lymphoma. Am J Hematol. 1997;54:79–83.

    Article  PubMed  CAS  Google Scholar 

  26. Hoey ET, Mankad K, Puppala S, Gopalan D, Sivananthan MU. MRI and CT appearances of cardiac tumours in adults. Clin Radiol. 2009;64:1214–30.

    Article  PubMed  CAS  Google Scholar 

  27. O’Donnell DH, Abbara S, Chaithiraphan V, Yared K, Killeen RP, Cury RC, et al. Cardiac tumors: optimal cardiac MR sequences and spectrum of imaging appearances. AJR Am J Roentgenol. 2009;193:377–87.

    Article  PubMed  Google Scholar 

  28. Araoz PA, Eklund HE, Welch TJ, Breen JF. CT and MR imaging of primary cardiac malignancies. Radiographics. 1999;19:1421–34.

    Article  PubMed  CAS  Google Scholar 

  29. Hoffmann U, Globits S, Schima W, Loewe C, Puig S, Oberhuber G, et al. Usefulness of magnetic resonance imaging of cardiac and paracardiac masses. Am J Cardiol. 2003;92:890–5.

    Article  PubMed  Google Scholar 

  30. Stein PD, Beemath A, Kayali F, Skaf E, Sanchez J, Olson RE, et al. Multidetector computed tomography for the diagnosis of coronary artery disease: a systematic review. Am J Med. 2006;119:203–16.

    Article  PubMed  Google Scholar 

  31. Kim YJ, Seo JS, Choi BW, Choe KO, Jang Y, Ko YG. Feasibility and diagnostic accuracy of whole heart coronary MR angiography using free-breathing 3D balanced turbo-field-echo with SENSE and the half-fourier acquisition technique. Korean J Radiol. 2006;7:235–42.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Sakuma H, Ichikawa Y, Chino S, Hirano T, Makino K, Takeda K. Detection of coronary artery stenosis with whole-heart coronary magnetic resonance angiography. J Am Coll Cardiol. 2006;48:1946–50.

    Article  PubMed  Google Scholar 

  33. Sakuma H, Ichikawa Y, Suzawa N, Hirano T, Makino K, Koyama N, et al. Assessment of coronary arteries with total study time of less than 30 min by using whole-heart coronary MR angiography. Radiology. 2005;237:316–21.

    Article  PubMed  Google Scholar 

  34. Jahnke C, Paetsch I, Schnackenburg B, Bornstedt A, Gebker R, Fleck E, et al. Coronary MR angiography with steady-state free precession: individually adapted breath-hold technique versus free-breathing technique. Radiology. 2004;232:669–76.

    Article  PubMed  Google Scholar 

  35. Dewey M, Teige F, Schnapauff D, Laule M, Borges AC, Rutsch W, et al. Combination of free-breathing and breathhold steady-state free precession magnetic resonance angiography for detection of coronary artery stenoses. J Magn Reson Imaging. 2006;23:674–81.

    Article  PubMed  Google Scholar 

  36. Cheng L, Ma L, Schoenhagen P, Ye H, Lou X, Gao Y, et al. Comparison of three-dimensional volume-targeted thin-slab FIESTA magnetic resonance angiography and 64-multidetector computed tomographic angiography for the identification of proximal coronary stenosis. Int J Cardiol. 2012. doi:10.1016/j.ijcard.2012.08.058.

    Google Scholar 

  37. Burke A, Jeudy Jr J, Virmani R. Cardiac tumours: an update: cardiac tumours. Heart. 2008;94:117–23.

    Article  PubMed  Google Scholar 

  38. Takaya T, Takeuchi Y, Nakajima H, Nishiki-Kosaka S, Hata K, Kijima Y, et al. Usefulness of transesophageal echocardiographic observation during chemotherapy for cardiac metastasis of non-Hodgkin lymphoma complicated with left ventricular diastolic collapse. J Cardiol. 2009;53:447–52.

    Article  PubMed  Google Scholar 

  39. Mallia A, Travaini L, Trifiro G, Paganelli G. Detection of a cardiac mass by [18F]FDG-PET/CT: a rare case. Ecancermedicalscience. 2009;3:152.

    PubMed  CAS  PubMed Central  Google Scholar 

  40. Tagami K, Tanda S, Kato H, Tashiro A, Saji K, Komaru T, et al. Detection of asymptomatic cardiac metastasis and successful salvage chemotherapy comprising a prednisone, Etoposide, procarbazine, and cyclophosphamide regimen in an elderly Japanese patient suffering from a delayed recurrence of diffuse large B-cell lymphoma. Case Rep Oncol. 2012;5:62–8.

    Article  PubMed  PubMed Central  Google Scholar 

  41. Castelli JB, Alexandre L, Futuro G, Scanavacca M, Soares Júnior J. Primary cardiac lymphoma detected by 18F-FDG PET scan: a case report. J Nucl Cardiol. 2011;18:974–7.

    Article  PubMed  Google Scholar 

  42. Makis W, Novales-Diaz JA, Lisbona R. Cardiac T-cell lymphoma imaged with F-18 FDG PET-CT and correlative imaging. Clin Nucl Med. 2010;35:332–4.

    Article  PubMed  Google Scholar 

  43. Cheng G, Newberg AB, Alavi A. Metastatic melanoma causing complete atrioventricular block – the role of FDG PET/CT in diagnosis. Clin Imaging. 2011;35:312–4.

    Article  PubMed  Google Scholar 

  44. Lu Y, Ulaner G. FDG PET/CT demonstration of right atrium metastasis overlooked on contrast-enhanced CT. Clin Nucl Med. 2011;36:405–6.

    Article  PubMed  Google Scholar 

Download references

Conflicts of interest

None.

Author information

Authors and Affiliations

  1. Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, Kita15, Nishi 7, kita-ku, Sapporo, Japan, 060-8638

    Yasuka Kikuchi, Noriko Oyama-Manabe & Satoshi Terae

  2. Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan

    Masanao Naya & Hiroyuki Tsutsui

  3. Department of Nuclear Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan

    Osamu Manabe & Nagara Tamaki

  4. Department of Biostatistics, Hokkaido University Graduate School of Medicine, Sapporo, Japan

    Yoichi M. Ito

  5. Department of Radiation Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan

    Hiroki Shirato

  6. Department of Surgical Pathology, Hokkaido University Hospital, Sapporo, Japan

    Kanako C. Hatanaka

Authors
  1. Yasuka Kikuchi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Noriko Oyama-Manabe
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Osamu Manabe
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Masanao Naya
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Yoichi M. Ito
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Kanako C. Hatanaka
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Hiroyuki Tsutsui
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Satoshi Terae
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Nagara Tamaki
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Hiroki Shirato
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Noriko Oyama-Manabe.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kikuchi, Y., Oyama-Manabe, N., Manabe, O. et al. Imaging characteristics of cardiac dominant diffuse large B-cell lymphoma demonstrated with MDCT and PET/CT. Eur J Nucl Med Mol Imaging 40, 1337–1344 (2013). https://doi.org/10.1007/s00259-013-2436-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00259-013-2436-5

Keywords

Search

Navigation