CTICasesPrimary Cardiac Diffuse Large B-cell Lymphoma of the Left Ventricle
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Imaging findings
Initial CT showed a pedunculated mass in the left ventricle, initially mistaken for a myxoma on echo. Retrospective review showed subtle thickening and hypoenhancement of the inferior wall, and decreased enhancement in the septum. MRI confirms a more diffuse process with slightly increased T1 signals, areas of decreased perfusion, and diffuse delayed enhancement in the septum, with a targetoid appearance of the lateral wall. Pathology confirmed diffuse large B-cell lymphoma confined to the left ventricle, with no other foci of lymphoma in the body.
Key takeaways
Primary cardiac lymphoma, especially diffuse large B-cell lymphoma involving the left ventricle, is rare and can mimic other cardiac masses like myxoma. Imaging findings like diffuse involvement, decreased perfusion, and specific enhancement patterns (targetoid, diffuse septal) can suggest lymphoma. Prognosis for primary cardiac lymphoma is generally poor, though some cases show good response to chemotherapy.
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