Pericardial constriction in double-hit lymphoma

  • Luke P. DawsonEmail author
  • Derk Pol
  • Sevastjan Kranz
  • Dinesh Sivaratnam
Images that Teach


Malignancies are infrequent causes of pericardial constriction.1 We present unusual 18-FDG-PET (Positron Emission Tomography) images of a patient with constriction secondary to double-hit lymphoma, a newly described subtype of diffuse large B-cell lymphoma.2

Case summary

An 81-year-old man presented with 6-months of progressive dyspnoea, orthopnoea and 10kg weight loss. Physical examination was notable for cachexia, peripheral oedema, and a positive Kussmaul’s sign. Electrocardiogram demonstrated normal sinus rhythm (Figure  1). Chest X-ray revealed bilateral pleural effusions and interstitial oedema (Figure  2). Computed tomography (CT) of the chest identified a large right pleural effusion with multiple soft tissue nodules within the pericardial space encasing the coronary arteries. Transthoracic echocardiogram demonstrated a bright pericardium (Figure  3) with a small effusion and septal bounce, and subsequent right heart catheterization confirmed constrictive physiology,...



The authors have no disclosures to declare.


  1. 1.
    Ghosh AK, Crake T, Manisty C, Westwood M. Pericardial disease in cancer patients. Curr Treat Options Cardiovasc Med 2018;20(7):60.CrossRefPubMedCentralGoogle Scholar
  2. 2.
    Swerdlow SH, Campo E, Pileri SA, Harris NL, Stein H, Siebert R, et al. The 2016 revision of the World Health Organization classification of lymphoid neoplasms. Blood 2016;127(20):2375–90.CrossRefPubMedCentralGoogle Scholar

Copyright information

© American Society of Nuclear Cardiology 2019

Authors and Affiliations

  • Luke P. Dawson
    • 1
    Email author
  • Derk Pol
    • 1
  • Sevastjan Kranz
    • 2
  • Dinesh Sivaratnam
    • 1
    • 3
  1. 1.Department of CardiologyRoyal Melbourne HospitalMelbourneAustralia
  2. 2.Deparment of PathologyRoyal Melbourne HospitalMelbourneAustralia
  3. 3.Department of Nuclear MedicineRoyal Melbourne HospitalMelbourneAustralia

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