Case Report: Application of multimodal imaging in the diagnosis and treatment evaluation of primary cardiac lymphoma

TL;DR

A rare heart lymphoma case is described, where advanced imaging techniques helped diagnose and monitor treatment success over several years.

Contribution

Demonstrates the critical role of multimodal imaging in the diagnosis and treatment evaluation of primary cardiac lymphoma.

Findings

Multimodal imaging enabled precise tumor localization and staging, leading to a confirmed PCL diagnosis.

The patient achieved complete remission after chemotherapy, confirmed by follow-up imaging.

Multimodal imaging is essential for clinical decision-making in PCL cases.

Abstract

Primary cardiac lymphoma (PCL) is an extremely rare malignancy. This report describes a 76-year-old woman who presented with chest tightness, exertional dyspnea, and nocturnal orthopnea. Multimodal imaging (echocardiography, CT, CMR, PET) was central to the diagnostic process, enabling precise tumor localization, non-invasive tissue characterization, and disease staging, thereby raising strong suspicion for PCL. The diagnosis of primary cardiac diffuse large B-cell lymphoma (non-germinal center subtype) was subsequently confirmed by histopathology. The patient achieved complete remission after five cycles of chemotherapy, which was confirmed on 6-month follow-up imaging, with no recurrence over 65 months of surveillance. This case highlights that multimodal imaging provides complementary information crucial for the comprehensive evaluation of PCL, serving as a cornerstone for evidence-based clinical decision-making throughout the diagnostic and therapeutic continuum, from initial suspicion and staging to treatment response assessment.

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