Why the study?
Primary cardiac lymphoma is extremely rare and definitive diagnosis can be delayed, increasing the likelihood of poor prognosis.
This case demonstrates that third-degree atrioventricular block secondary to primary cardiac B-cell lymphoma can be successfully reversed with appropriate chemotherapy and pacemaker implantation.
Answers are grounded in this paper and cite their sources.
May support chemotherapy plus pacing for reversible AV block in cardiac lymphoma; leaves open generalizability beyond single cases.
Primary cardiac tumors are extremely uncommon and primary cardiac lymphoma (PCL) is an even rarer subset. A definite diagnosis can be delayed, which increases the likelihood of a poor prognosis. We report a case involving a 64-year-old male who presented with dyspnea, palpitation, and third-degree atrioventricular block (AVB) secondary to primary cardiac B-cell lymphoma that was diagnosed via endomyocardial biopsy (EMB) and multimodality imaging. Chemotherapy was initiated using rituximab, cyclophosphamide, vindesine, and prednisone (R-COP) followed by implantation of an artificial capsule pacemaker. Third-degree AVB vanished, and the subsequent cycle of treatment was adjusted as R-CDOP (rituximab, cyclophosphamide, doxorubicin liposome, vindesine, and prednisone), with aspirin and rosavastatin to prevent ischemic events. So far, the patient had a good clinical course and normal electrocardiogram. This case underscores the importance of EMB in the diagnosis of heart neoplasms. It is worth noting that anthracycline is not contraindicated in PCL.
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Mao et al. (2023) studied this question.
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