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(Circulation. 2000;101:e179.)
© 2000 American Heart Association, Inc.

Circulation Electronic Pages

Primary Cardiac Lymphoma Diagnosed With Transesophageal Echocardiography–Guided Endomyocardial Biopsy

F. Burling, MB, ChB; G. Devlin, MB, BCh, FRACP; S. Heald, MB, ChB, FRACP

From the Department of Cardiology, Waikato Hospital, Hamilton, New Zealand.

Correspondence to Dr G. Devlin, Cardiologist, Waikato Hospital, Pembroke St, Private Bag 3200, Hamilton, New Zealand. E-mail devling{at}hwl.co.nz

	Introduction

Top Introduction

 
A 77-year-old woman presented with a 10-month history of tiredness, shortness of breath, and ankle swelling. Examination revealed signs consistent with right heart failure with marked peripheral edema and auscultatory evidence consistent with tricuspid stenosis.

Transthoracic echocardiography showed a large right atrial mass impinging on the tricuspid valve causing functional tricuspid stenosis (Figure 1).

View larger version (116K): [in this window] [in a new window]   Figure 1. Four-chamber transthoracic echocardiogram showing large mass almost completely obliterating right atrium (RA), invading tricuspid valve (Tri) apparatus, and extending into right ventricle (RV). LV indicates left ventricle; AO, aortic valve; and LA, left atrium.

Endomyocardial biopsy was performed under transesophageal echocardiographic guidance (Figure 2).

View larger version (113K): [in this window] [in a new window]   Figure 2. Biplane transesophageal echocardiographic guidance biopsy of right atrial mass. F indicates forceps; RA, right atrium.

Histology confirmed B-cell lymphoma, and radiotherapy was begun. At 1-month follow-up, transthoracic echocardiography showed the right atrial mass to have decreased significantly in size (Figure 3).

View larger version (114K): [in this window] [in a new window]   Figure 3. Follow-up transthoracic 4-chamber echocardiogram after radiotherapy for cardiac lymphoma. Previously noted mass in right ventricle and right atrium has decreased significantly in size. Abbreviations as in Figure 1.

	Footnotes

 
The editor of Images in Cardiovascular Medicine is Hugh A. McAllister, Jr, MD, Chief, Department of Pathology, St Luke’s Episcopal Hospital and Texas Heart Institute, and Clinical Professor of Pathology, University of Texas Medical School and Baylor College of Medicine.

Circulation encourages readers to submit cardiovascular images to the Circulation Editorial Office, St Luke’s Episcopal Hospital and Texas Heart Institute, 6720 Bertner Ave, MC1-267, Houston, TX 77030.

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This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Burling, F. Articles by Heald, S. Search for Related Content PubMed PubMed Citation Articles by Burling, F. Articles by Heald, S. Related Collections Other Research Echocardiography Other diagnostic testing