From the radiologic pathology archives: Cardiac lymphoma: Radiologic-pathologic correlation

Abstract

Cardiac lymphomas are rare and have imaging features nonspecific enough to present a diagnostic challenge. They are commonly of B-cell origin and manifest as an ill-defined, infiltrative mass. Chest radiographs are frequently abnormal, reflecting the location and extent of tumor and prompting further investigation. Although echocardiography is often the initial imaging modality, cardiac lymphomas are better depicted with CT and MR imaging because of the superior soft-tissue contrast. Atrial location is typical, with infiltration of atrial or ventricular walls. Pericardial thickening and effusion is also common and can sometimes be the only earliest sign of disease. Lymphomas may have high or low signal intensity at MR imaging, may be isoattenuating or hypoattenuating to muscle at CT, and may show increased or decreased contrast enhancement. Unlike with other cardiac tumors, treatment is not primarily surgical but includes anthracycline-based chemotherapy and anti-CD20 treatment. ©RSNA, 2012.