# Fibrin-Associated Large B-Cell Lymphoma of Prosthetic Aortic Valve and Aortic Root Graft

## TL;DR

A rare case of lymphoma growing on a prosthetic aortic valve is described, highlighting its unique features and non-aggressive behavior after surgery.

## Contribution

The paper introduces Fibrin-Associated Large B-Cell Lymphoma (FA-LBCL) as a distinct subtype based on clinical and pathological observations.

## Key findings

- The lymphoma was EBV-positive and developed on a prosthetic aortic valve 9 years after surgery.
- The tumor was non-aggressive and showed no recurrence after surgical removal over 59 months of follow-up.
- FA-LBCL is distinguished by its unique clinical and pathological characteristics.

## Abstract

Background and clinical significance: Primary cardiac diffuse large B-cell lymphoma (DLBCL) arising in bioprosthetic valves is exceedingly rare. Most patients present with localized disease often masquerading as suspected thrombi or vegetations. Imaging studies are inconclusive and due to the rarity of the disease, treatment and follow-up data are very limited. Case presentation: We present one such case developing 9 years after aortic valve replacement in an otherwise immunocompetent patient, who presented with minor symptoms despite significant disease burden. This tumor contained Epstein–Barr virus (EBV), was confined to the site of origin, and has behaved non-aggressively after excision with a follow-up of 59 months. Conclusions: This unique disease is classified as Fibrin-associated large B-cell lymphoma (FA-LBCL) in view of its distinct clinical-pathological features. This report also addresses the unique features of this type of lymphoma.