Large B-Cell Lymphoma Invading the Heart

Figures

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  Figure 1. Computed Tomography Angiography Showing a Large Mass (A) Chest x-ray showing a large mass invading the left hemithorax. (B) Axial computed tomography angiography view of the pulmonary trunk (PT), right pulmonary artery (RPA), left pulmonary artery (LPA), and mass (asterisk) compressing the pulmonary trunk and the RPA. (C) Sagittal computed tomography angiography view of the PT, right ventricle (RV), and mass compressing the pulmonary trunk. (D) Coronal computed tomography angiography view of the ascending aorta (AO), left anterior descending coronary artery (LAD), left ventricle (LV), and mass surrounding the proximal to mid-portion of the LAD.

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  Figure 2. Cardiac Magnetic Resonance Cine Images Cardiac magnetic resonance cine steady-state free precession images in diastole (A, C, and E) and systole (B, D, and F). Open asterisks correspond to the mass that does not present a clear demarcation between the tumor and surrounding myocardial tissue. Closed asterisks indicate a pleural effusion of moderate size. LA = left atrium; RA = right atrium; other abbreviations as in Figure 1.

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  Figure 3. Cardiac Magnetic Resonance Tissue Characterizations (T2 and LGE Imaging) Cardiac magnetic resonance images in T2 with fat saturation in axial (A) and short-axis views (C) highlighting hyperintense areas within the mass (asterisks), which infiltrates the LV and surrounds the proximal portion of the LAD (arrow). (B and D) Late gadolinium enhancement images in 4-chamber (B) and short-axis (D) views showing transmural scarring within the anterior LV wall (arrows). Abbreviations as in Figure 1.

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  Visual Summary. Multimodality Imaging Features of Cardiac Involvement in Large B-Cell Lymphoma This figure demonstrates the complementary roles of echocardiography, cardiac computed tomography, and cardiac magnetic resonance (CMR) in assessing cardiac involvement by diffuse large B-cell lymphoma. Echocardiography (Left, A and B). Parasternal long-axis views show a large hypoechoic mass (arrowheads) infiltrating the right ventricular outflow tract (RVOT) and anterior wall, causing external compression of the pulmonary trunk (PT). Color Doppler imaging demonstrates turbulent flow due to partial obstruction. Cardiac computed tomography (Middle, A to D). Contrast-enhanced images depict a lobulated soft tissue mass (asterisk) in the anterior mediastinum encasing the PT and proximal right pulmonary artery (RPA) without intraluminal invasion. Reformatted sagittal and coronal views define the relationship with the right ventricle (RV) and ascending aorta (AO). CMR (Right, A to F). CMR confirms a large infiltrative anterior mediastinal mass (asterisk) extending into the pericardial space and contiguous with the RV free wall. Cine steady-state free precession images show mild external compression but…