CTICasesSecondary Cardiac Lymphoma
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Imaging findings
Cardiac MRI demonstrates a large, T2-hyperintense, lobulated, infiltrative mass centered at the crux of the heart. The mass extends into the retroaortic and epicardial regions, encasing and narrowing the coronary sinus, and infiltrating the myocardium, interventricular septum, interatrial septum, and right ventricular apex. Follow-up MR images show a rapid decrease in the size of the mass and resolution of coronary sinus compression after 5 days of chemotherapy.
Key takeaways
Secondary cardiac involvement by lymphoma (typically non-Hodgkin lymphoma) is much more common than primary cardiac lymphoma and often presents as an infiltrative epicardial or myocardial mass that spreads along the crux of the heart. Cardiac lymphoma characteristically demonstrates T1-isointensity, T2-hyperintensity, heterogeneous enhancement, and a rapid, dramatic response to even a short course of chemotherapy.
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