Early Surgical Intervention in a Case of Primary Cardiac Lymphoma in an Immunocompetent 56-Year-Old Male

Figures

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  Figure 1. Preoperative 12-lead EKG.

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  Figure 2. Preoperative transthoracic echocardiogram in parasternal short-axis view at the level of the aortic valve. The orange numbered labels represent the following structures: right atrial mass (1), right atrium (2), right ventricular outflow (3), aortic valve in short axis (4), and the left atrium (5).

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  Figure 3. Right upper quadrant abdominal ultrasound in transverse axis, performed preoperatively. The orange arrows are pointing to the gallbladder in the center of the image. Yellow arrows are found outside of the gallbladder wall pointing to an anechoic focus that is concerning for pericholecystic fluid.

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  Figure 4. CT of the chest with contrast (coronal view) displaying the 5.8 cm right atrial mass, circled in yellow.

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  Figure 5. CT of the chest with contrast (axial view) displaying the 5.8 cm right atrial mass, circled in yellow.

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  Figure 6. Intraoperative transesophageal echocardiography with the mid-esophageal four-chamber view demonstrating the right atrial mass. The orange numbered labels are as follows: mass measurement at 5.27 cm × 5.19 cm (1), right ventricle (2), right atrium (3), left ventricle (4), and left atrium (5).

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  Figure 7. Mid-esophageal modified bicaval view on transesophageal echocardiography. The orange numbered labels are as follows: right-sided cardiac mass (1), right ventricle inflow (2), right atrium (3), superior vena cava (4), and left atrium (5).

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  Figure 8. Operative view in the surgical field, with yellow arrows pointing to the right atrial mass.

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  Figure 9. Mass displayed on a surgical sponge, with orange arrows pointing to the right atrial mass after resection.

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  Figure 10. Low-power histopathological image of the resected right atrial mass.

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  Figure 11. High-power histopathological image of the resected right atrial mass.

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  Figure 12. Postoperative 12-lead EKG with conduction system changes from baseline EKG showing complete heart block.