Skip to main content
Download PDF

A male with multiple cardiac masses

Echo Research & Practice volume 5, pages K53–K58 (2018)Cite this article

Summary

Thirty-seven-year-old male presented with cough, dyspnea, significant weight loss (20 kg) and subacute fever for the past 2 months. Physical examination revealed inspiratory and expiratory wheezing bilaterally. A normal S1, S2 and a 3/6 systolic ejection murmur at the left upper parasternal border with respiratory variation were found during cardiac auscultation. Kidney and bone marrow biopsy reported a high-grade B-cell lymphoma. Echocardiography and cardiac CT findings consisted of multiple intracardiac masses affecting the right ventricular (RV) outflow track, RV apex, medial portion of the right atrium and posterior left atrium, as well as mild impairment of the RV systolic function. The masses in the RV outflow track caused partial obstruction (pulmonary valve peak velocity 2.3 m/s) with a RV systolic pressure of 43 mmHg. The infiltrative mass in the interatrial septum extended into both the right and left atrial cavities. The right superior pulmonary vein was occluded. This patient was treated with aggressive chemotherapy and had a good clinical response that resulted in mass size reduction after the first course of chemotherapy. Multimodality imaging techniques such as echocardiography, cardiac CT and PET scan can provide complementary information to better evaluate, stage and manage these patients.

References

  1. Petrich A, Cho SI, Billett H. Primary cardiac lymphoma. An analysis of presentation, treatment and outcome patterns. Cancer 2011117 581–589. (https://doi.org/10.1002/cncr.25444)

    Article  Google Scholar 

  2. Bradham RR, Parker EF, Greene WB. Lymphatics of the atrioventricular valves. Archives of Surgery 1973106 210–213. (https://doi.org/10.1001/archsurg.1973.01350140068019)

    Article  CAS  Google Scholar 

  3. Johri A, Baetz T, Isotalo PA, Nolan RL, Sanfilippo AJ, Ropchan G. Primary cardiac diffuse large B cell lymphoma presenting with superior vena cava syndrome. Canadian Journal of Cardiology 200925 e210–e212. (https://doi.org/10.1016/S0828-282X(09)70110-2)

    Article  Google Scholar 

  4. Jonavicius K, Salcius K, Meskauskas R, Valeviciene N, Tarutis V, Sirvydis V. Primary cardiac lymphoma: two cases and a review of literature. Journal of Cardiothoracic Surgery 201510 138. (https://doi.org/10.1186/s13019-015-0348-0)

    Article  Google Scholar 

  5. Baztarrica GP, Nieva N, Gariglio L, Salvaggio F, Porcile R. Primary cardiac lymphoma: a rare case of pulmonary tumor embolism. Circulation 2010121 2249–2250. (https://doi.org/10.1161/CIRCULATIONAHA.109.863126)

    Article  Google Scholar 

  6. Mahony DO, Piekarz RL, Bandettini WP, Arai AE, Wilson WH, Bates SE. Cardiac involvement with lymphoma: a review of the literature. Clinical Lymphoma and Myeloma 20088 249–252. (https://doi.org/10.3816/CLM.2008.n.034)

    Article  Google Scholar 

  7. Mankad R, Herrmann J. Cardiac tumors: echo assessment. Echo Research and Practice 20163 R65–R77. (https://doi.org/10.1530/ERP-16-0035)

    Article  Google Scholar 

  8. Jeudy J, Kirsch J, Tavora F, Burke AP, Franks TJ, Mohammed TL, Frazier AA, Galvin JR. Cardiac lymphoma: radiologic-pathologic correlation. RadioGraphics 201232 1369–1380. (https://doi.org/10.1148/rg.325115126)

    Article  Google Scholar 

  9. Ragland MM, Tak DO, Tak T. The role of echocardiography in diagnosing space-occupying lesions of the heart. Clinical Medicine and Research 20064 22–32.

    Article  Google Scholar 

  10. Tilly H, da Silva MG, Vitolo U, Jack A, Meignan M, Guillermo AL, Walewski J, André M, Johnson PW, Pfreundschuh M, et al. Diffuse large B-cell lymphoma (DLBCL): ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Annals of Oncology 201526 (Supplement 5) v116–v125. (https://doi.org/10.1093/annonc/mdv304)

    Article  Google Scholar 

Download references

Funding

This work did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.

Author information

Authors and Affiliations

  1. Cardiovascular Diseases Department, Mayo Clinic, Rochester, Minnesota, USA

    Manasawee Indrabhinduwat MD, Maria C. Arciniegas Calle MD, Joseph P. Colgan MD & Hector R. Villarraga MD

  2. Bhumibol Adulyadej Hospital, Bangkok, Thailand

    Manasawee Indrabhinduwat MD

Authors
  1. Manasawee Indrabhinduwat MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Maria C. Arciniegas Calle MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Joseph P. Colgan MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Hector R. Villarraga MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Hector R. Villarraga MD.

Rights and permissions

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.(http://creativecommons.org/licenses/by/4.0/), which permits use, duplication, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license and indicate if changes were made.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Indrabhinduwat, M., Arciniegas Calle, M.C., Colgan, J.P. et al. A male with multiple cardiac masses. Echo Res Pract 5, K53–K58 (2018). https://doi.org/10.1530/ERP-18-0023

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1530/ERP-18-0023

Key Words

Echo Research & Practice

ISSN: 2055-0464

Contact us