Synchronous Cardiac and Central Nervous System Diffuse Large B-Cell Lymphoma

Figures

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  Figure 1. Pretreatment two-dimensional TTE, apical 4-chamber (A) and parasternal short-axis (B) systolic views, demonstrates a large irregular, heterogenous, echodense RA (yellow arrow) and RV (red arrows) mass measuring 5.0 × 4.0 × 8.0 cm with associated pericardial effusion. Pretreatment cardiac PET-fluorodeoxyglucose scan (C) demonstrates increased radiotracer uptake (red arrow) consistent with the large right-sided cardiac mass seen on TTE.

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  Figure 2. Hematoxylin and eosin stain (A) demonstrates diffuse infiltrate of large atypical lymphoid cells (×600 magnification). CD20 immunohistochemistry stain (B) demonstrates diffuse membranous activity within the lymphoma (×400 magnification).

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  Figure 3. Posttreatment two-dimensional TTE, apical 4-chamber (A) and parasternal short-axis (B) systolic views, demonstrates resolution of the previously noted large right heart mass. Posttreatment cardiac PET-fluorodeoxyglucose scan (C) demonstrates resolution of the previously noted radiotracer uptake.

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  Figure 4. Timeline of relevant clinical, diagnostic, and treatment events throughout the patient’s journey.