Disseminated HIV-Associated Burkitt Lymphoma With Cardiac and Presumed Central Nervous System Involvement

BACKGROUND: Cardiac involvement in Burkitt lymphoma (BL) is rare, with fewer than 30 cases reported in the literature. Contrast echocardiography can characterize intracardiac masses in resource-limited settings, although multimodal imaging is paramount. CASE SUMMARY: A 52-year-old man with HIV presented with axillary lymphadenopathy, constitutional symptoms, and a left oculomotor nerve palsy. Imaging revealed splenic lesions and a right atrial mass. Contrast echocardiography demonstrated vascularity of the mass with invasion into the crux. Cardiac magnetic resonance imaging confirmed involvement of the atrial and ventricular septum. He was diagnosed with Ann Arbor stage 4 HIV-associated BL and started on R-hyperCVAD, with resolution of the cardiac mass after 2 months of treatment. DISCUSSION: This is a rare case of disseminated BL with combined atrial and ventricular septal involvement, not previously reported. TAKE-HOME MESSAGE: Early multimodal cardiac imaging in disseminated BL disease is important regardless of presenting cardiac symptoms.