Key result
Immunohistochemical evaluation of a cardiac mass in a 70-year-old man confirmed diffuse large B-cell lymphoma with a 70-80% proliferation index.
Why the study?
Diffuse large B-cell lymphoma of the heart accounts for only 1% of primary cardiac tumors, with histopathologic and immunohistochemical evaluation being critical for subtype determination, disease progression prediction, and therapeutic planning.
Case Report (n=1)
Highlights the role of histopathologic and immunohistochemical evaluation in diagnosing rare primary cardiac tumors like diffuse large B-cell lymphoma.
Cardiac masses require biopsy with IHC for lymphoma subtyping; leaves open optimal management strategies for primary cardiac DLBCL.
Diffuse large B-cell lymphoma (DLBCL) of the heart accounts for only 1% of primary cardiac tumors. Histopathologic examination becomes the primary key for diagnosis and immunohistochemical evaluation for non-Hodgkin lymphoma (NHL) subtype determination is able to predict disease progression and therapeutical modality. Case description: 70-year-old man complained of shortness of breath. Echocardiographic examination revealed mass occupied the left atrium measured 5.9 x 2.9 cm inherent with interatrial septum and mass with a stem in the right atrium measured 4.6 x 2.4 cm. Intraoperative, considerable amount of extracardiac mass was found, mass extension was unable to be determined. Thoracic surgeon decided to sample the extracardiac mass without performing cardiac surgery. The histopathologic features showed round blue cell tumor resembling a NHL. Immunohistochemical staining were consistent with diffuse NHL, large cell, high grade lymphoma, suitable for DLBCL. Round blue cell tumor of extracardiac mass with positive expression of LCA and CD 20 is suitable for B-cell non-Hodgkin lymphoma. Ki-67 immunohistochemical staining revealed a 70-80% proliferation index which indicates a high-grade lymphoma and defining diagnosis and treatment of DLBCL.
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Tirtasari et al. (2022) conducted a case report in Diffuse large B-cell lymphoma of the heart (n=1). Immunohistochemical evaluation of a cardiac mass in a 70-year-old man confirmed diffuse large B-cell lymphoma with a 70-80% proliferation index.
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