Primary Cardiac Diffuse Large B-Cell Lymphoma Managed With Rituximab, Etoposide, Prednisone, Vincristine, Cyclophosphamide, and Doxorubicin (R-EPOCH): A Case Report and Literature Review

TL;DR

A rare case of primary cardiac lymphoma was successfully treated with a specific chemotherapy regimen, highlighting the need for early detection and interdisciplinary care.

Contribution

This case report presents a rare instance of primary cardiac diffuse large B-cell lymphoma successfully managed with R-EPOCH chemotherapy.

Findings

The patient experienced resolution of palpitations and reduction in cardiac mass after R-EPOCH treatment.

Primary cardiac lymphomas require early detection and interdisciplinary management for improved survival.

Abstract

Diffuse large B-cell lymphoma (DLBCL) is the most common subtype of non-Hodgkin’s lymphoma. However, primary cardiac involvement is rare, often presenting with subtle and atypical symptoms that complicate diagnosis and management. We present the case of a 60-year-old man who presented with intermittent palpitations of unclear origin, later identified as ventricular tachycardia. Imaging showed a right ventricular cardiac mass, and biopsy confirmed a diagnosis of DLBCL. He was treated with the chemotherapy regimen rituximab, etoposide, prednisone, vincristine, cyclophosphamide, and doxorubicin (R-EPOCH), resulting in symptomatic resolution of palpitations and a reduction in the size of the cardiac mass. Early detection is crucial to improving survival in primary cardiac lymphomas and highlights the importance of an interdisciplinary approach in managing this rare cardiac malignancy.

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