Key result
Corticosteroids and immunochemotherapy (DA-R-EPOCH) achieved complete remission in a 69-year-old man presenting with MINOCA secondary to diffuse large B-cell lymphoma.
Why the study?
The varied cardiovascular manifestations of lymphoma and the importance of differential diagnosis in patients presenting with myocardial infarction with non-obstructive coronary arteries (MINOCA) are not well characterized.
Case Report (n=1)
This case highlights the importance of maintaining a broad differential diagnosis, including infiltrative malignancies like lymphoma, in patients presenting with features of myocardial infarction with non-obstructive coronary arteries (MINOCA).
Answers are grounded in this paper and cite their sources.
Cardiac lymphoma may mimic STEMI; this Level 5 case leaves open optimal diagnostic pathways in non-obstructive presentations.
A 69-year-old man presented with sudden-onset crushing chest pain, diaphoresis, and syncope with ECG findings prompting treatment as a ST-elevation myocardial infarction (STEMI). Emergency coronary angiography demonstrated no obstructive coronary artery disease. Subsequent investigations including cardiac magnetic resonance imaging (MRI) and positron emission tomography (PET) scan demonstrated an infiltrative mass. Biopsy of a supraclavicular lymph node established a diagnosis of diffuse large B-cell lymphoma (DLBCL) with cardiac involvement. The patient was treated with corticosteroids and immunochemotherapy (DA-R-EPOCH), achieving complete remission on surveillance imaging. This case therefore contributes valuable evidence regarding the varied cardiovascular manifestations of lymphoma and reinforces the importance of maintaining a broad differential diagnosis in patients presenting with features of myocardial infarction with non-obstructive coronary arteries (MINOCA).
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Deshpande et al. (2026) conducted a case report in Myocardial infarction with non-obstructive coronary arteries (MINOCA); Diffuse large B-cell lymphoma (DLBCL) (n=1). Corticosteroids and immunochemotherapy (DA-R-EPOCH) was evaluated on Complete remission. Corticosteroids and immunochemotherapy (DA-R-EPOCH) achieved complete remission in a 69-year-old man presenting with MINOCA secondary to diffuse large B-cell lymphoma.
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