# Surviving the Odds: Primary Cardiac Lymphoma With Locoregional Lymph Node Involvement Complicated by Pericardial Effusion and Arrhythmia

## TL;DR

This case report describes a rare instance of primary cardiac lymphoma presenting with heart block and lymph node involvement, highlighting the challenges in diagnosis and treatment.

## Contribution

The paper presents a unique clinical case of primary cardiac lymphoma with locoregional lymph node involvement and arrhythmia.

## Key findings

- The patient presented with syncope, pericardial effusion, and complete heart block.
- FDG-avid lymph node biopsy confirmed diffuse large B-cell lymphoma.
- Chemotherapy was the main treatment approach for this rare condition.

## Abstract

Primary cardiac lymphoma (PCL) is a rare malignant disease and its presentation varies depending on the degree of infiltration and location in the myocardium; hence its diagnosis can be challenging. We present a case of a 67-year-old otherwise healthy male who initially presented with recurrent syncope found to have a pericardial effusion and complete heart block. Paratracheal biopsy of a fluorodeoxyglucose (FDG)-avid lymph node was consistent with diffuse large B-cell lymphoma. Diagnosis is usually identified histologically, but imaging is key in guiding biopsy and monitoring disease regression. Chemotherapy is the mainstay of treatment. In this case report, we present a unique presentation of primary cardiac lymphoma presenting as complete heart block with extra-cardiac lymph node involvement and review its management.