What is the clinical evidence from this study?

Study design: Case Report. Population: Diffuse Large B-Cell Lymphoma with cardiac involvement (n=1). Intervention: R-daEPOCH chemoimmunotherapy. Primary outcome: Complete metabolic remission confirmed by PET imaging.

What does this research mean for the field?

Chemoimmunotherapy can lead to complete metabolic remission in patients presenting with cardiac diffuse large B-cell lymphoma. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

February 26, 2026Open Access

Cardio-Hematology Crossroads: A Diffuse Large B-Cell Lymphoma Case Presenting with a Cardiac Mass

Key Result

R-daEPOCH chemoimmunotherapy led to complete metabolic remission in a patient with cardiac diffuse large B-cell lymphoma after 6 cycles of treatment.

Key Points

To demonstrate the challenges in diagnosing cardiac involvement by diffuse large B-cell lymphoma and the importance of early intervention.
Case report of a 58-year-old male with cardiac symptoms
Utilized transthoracic echocardiography to identify a right atrial mass
Performed 18F-FDG PET-CT for further assessment
Conducted biopsy of left superior cervical lymph node
Administered six cycles of chemoimmunotherapy
Confirmed diagnosis of diffuse large B-cell lymphoma through biopsy
Achieved complete metabolic remission after treatment
Highlighted the necessity for early imaging and diagnosis in similar cases
Demonstrated potential improvement in clinical outcomes with prompt therapy

Study Design

Type

Case Report (n=1)

Multicenter

Structured PICO

Population

1 58-year-old male presenting with dyspnea, malaise, fingertip numbness, weight loss, and shoulder pain, found to have a right atrial mass.

Intervention

Six cycles of chemoimmunotherapy

Outcome

Complete metabolic remission

Lymphoid malignancies should be considered in the differential diagnosis of intracardiac masses, requiring early multimodal imaging and prompt histopathological confirmation.

Limitations

Single patient case report limits generalizability.
No control or comparator group.
Lack of long-term follow-up data.
No statistical analysis due to study design.

Abstract

Cardiac involvement by diffuse large B-cell lymphoma (DLBCL) is a rare clinical entity that often presents with nonspecific symptoms, making early diagnosis particularly challenging. In this context, we report a case that highlights the diagnostic obstacles and the importance of early evaluation. A 58-year-old male presented with dyspnea, malaise, fingertip numbness, weight loss, and shoulder pain. Transthoracic echocardiography revealed a right atrial mass, prompting further assessment. Positron Emission Tomography-Computed Tomography demonstrated increased 18F-FDG (18F-fluorodeoxyglucose) uptake in multiple regions, including the cardiac musculature, raising suspicion for disseminated lymphoproliferative disease. The biopsy of the left superior cervical lymph node confirmed diffuse large B-cell lymphoma. The patient underwent six cycles of chemoimmunotherapy and achieved complete metabolic remission. This case underscores the need to consider lymphoid malignancies in the differential diagnosis of intracardiac masses and persistent cardiac symptoms without an obvious cause. Early use of multimodal imaging and prompt histopathological confirmation are critical for accurate diagnosis and appropriate treatment planning. Rapid initiation of immunochemotherapy may improve clinical outcomes and reduce the risk of severe cardiac complications.

Bookmark

View Full Paper