Precursor B-Cell Lymphoblastic Primary Cardiac Lymphoma Ã¢ÂÂ Case Report and Review of Literature
- *Corresponding Author:
- Dipesh Uprety
Department of Internal Medicine
Abington Memorial Hospital
1200 Old York Road
Abington PA 19001, US
E-mail: [email protected]
Received Date: November 23, 2014; Accepted Date: January 22 2015; Published Date: January 31, 2015
Citation: Umakanthan JM, Uprety D, Banda K, Victor N, Auerbach H (2015) Precursor B-Cell Lymphoblastic Primary Cardiac Lymphoma – Case Report and Review of Literature. J Blood Lymph 5:133. doi: 10.4172/2165-7831.1000133
Copyright: © 2015 Umakanthan JM, This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Primary cardiac lymphoma (PCL) is an extremely rare malignancy and an uncommon presentation of Non-Hodgkin’s Lymphoma. We report the first case of Precursor B-cell lymphoblastic PCL. A 44 year old Caucasian woman presented to our institution with one week history of worsening dyspnea, leg swelling and a weight gain of 12 pounds. Urgent echocardiography revealed pericardial effusion with tamponade physiology. Subsequent imaging showed a mass in the right atrio-ventricular groove. Pericardiocentesis was performed and cytopathology showed malignant appearing immature lymphocytes. Immunophenotypic analysis revealed 85% of the cells to be CD19 and CD10 positive. The cells were negative for CD20, surface light chains, CD3 and CD5 consistent with immature B-cells. Terminal deoxynucleotidyl Transferase (TDT) was strongly positive confirming Precursor B-cell Lymphoblastic Lymphoma. Clinical presentation of PCL can be varied and can mimic non-neoplastic primary cardiac problems. When PCL is suspected and a pericardial effusion is present, pericardial fluid analysis can be a reasonable first step. If diagnostic, it can avoid further invasive procedures. Chemotherapy remains the standard treatment and should be initiated early given the aggressive nature of these high grade lymphomas. Surgery is needed only in selected cases with obstructive features.