CTICasesCardiac Lymphoma (Secondary) with Pericardial Effusion
Imaging findings
CT demonstrates a large, very low-attenuation intracardiac mass predominantly in the right atrium and prolapsing across the tricuspid valve into the right ventricle, with associated pericardial effusion. Bulky superior mediastinal lymphadenopathy is present. The mass shows minimal arterial-phase enhancement.
Key takeaways
Cardiac lymphoma is the most common primary cardiac malignancy after angiosarcoma, and secondary involvement is far more common than primary. Key features distinguishing lymphoma from angiosarcoma include very low CT attenuation (lymphoma) versus heterogeneous enhancement, location in the right atrium rather than the right AV groove, simple rather than hemorrhagic pericardial effusion, and associated extra-cardiac lymphadenopathy. Lymphoma should be in the differential for any low-attenuation intracardiac mass.
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