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January 20, 2026Case Reports in Oncological Medicine0 citationsOpen Access

When the Heart Is the Target: Case of Primary Pericardial Diffuse Large B‐Cell Lymphoma Presenting With Tamponade

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ABAmeed BawwabLKLana KhatibMAMoath Ahmad Salman Albliwi

Key Result

Treatment with mini-R-CHOP chemotherapy resulted in marked clinical improvement in a patient with primary pericardial diffuse large B-cell lymphoma presenting with tamponade.

Key Points

  • To present a rare case of primary pericardial diffuse large B-cell lymphoma with clinical implications for diagnosis and treatment.
  • Case report of a patient presenting with cough and hypoxic respiratory failure.
  • Transthoracic echocardiography was used to assess pericardial effusion size.
  • Pericardiocentesis was performed for fluid analysis and cytology evaluation.
  • Pericardial fluid cytology confirmed diffuse large B-cell lymphoma as the primary site.
  • The patient showed clinical improvement after treatment with mini-R-CHOP chemotherapy.
  • Initial imaging revealed rapid progression of pericardial effusion over one week.

Study Design

Type

Case Report (n=1)

Structured PICO

P
Population
A single patient presenting with cough, shortness of breath, and acute hypoxic respiratory failure, diagnosed with primary pericardial diffuse large B-cell lymphoma.
I
Intervention
Pericardiocentesis followed by mini-R-CHOP chemotherapy
O
Outcome
Clinical improvement and resolution of metabolic activity on PET scan

Primary pericardial DLBCL is an extremely rare cause of pericardial effusion and tamponade that can be successfully diagnosed via pericardiocentesis cytology and treated with mini-R-CHOP chemotherapy.

Abstract

Diffuse large B‐cell lymphoma (DLBCL) is an aggressive malignancy and the most common subtype of non‐Hodgkin lymphoma, typically presenting with lymphadenopathy. Pericardial involvement is extremely rare. We report the case of a patient who presented with cough and shortness of breath and was admitted for acute hypoxic respiratory failure. During hospitalization, the patient developed atrial fibrillation with rapid ventricular response (RVR). Transthoracic echocardiography revealed a pericardial effusion, which increased in size on repeat imaging 1 week later. The patient subsequently underwent pericardiocentesis, and cytology of the pericardial fluid confirmed DLBCL, with the pericardium identified as the primary site of involvement. The patient was treated with mini‐R‐CHOP chemotherapy, resulting in marked clinical improvement.

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Cite This Study

Bawwab et al. (2026) conducted a case report in Primary Pericardial Diffuse Large B-Cell Lymphoma (n=1). mini-R-CHOP chemotherapy was evaluated on Clinical improvement. Treatment with mini-R-CHOP chemotherapy resulted in marked clinical improvement in a patient with primary pericardial diffuse large B-cell lymphoma presenting with tamponade.

synapsesocial.com/papers/696f1a9f9e64f732b51eee2ahttps://doi.org/10.1155/crom/9885772
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