Value of computed tomography evaluation in the detection of cardio-pericardial lymphomatous involvement

Leukemia and malignant lymphoma are most likely to involve the cardiac chambers and pericardium, often by contiguous direct extension from a mediastinal mass. Our study’s objective is to discuss and illustrate computed tomography (CT) findings in both cardiac and pericardial involvement in patients diagnosed with a hematologic malignancy and radiologic evidence of a mediastinal mass. We reviewed our database for a period of ten years (between January 2010 and March 2020) and we selected four patients with radiologic evidence of a mediastinal mass and tumoral extension in cardio-pericardial struc­tures, in the context of a hematologic malignancy. All our patients have been investigated by CT and were diagnosed with non-Hodgkin lymphoma. In three cases, we found intraatrial extension of the tumoral mass, in one case with both atria affected. Tumoral encasement and obstruction of the superior pulmonary veins were noted in two cases, and CT signs of superior vena cava syndrome (SVCS) were noted in two cases with direct invasion and venous com­pres­sion by the tumoral mass. CT is an investigation de­di­ca­ted to the evaluation of cardio-pericardial tumoral ex­ten­sion in cases of malignant hematological disease, allowing to detect the extent of tumoral involvement or to assess tho­ra­cic emergency conditions (SVCS cardiac tamponade, pul­mo­na­ry embolism).