Asian Oncology Research Journal

Primary Cardiac Lymphoma Diagnosed and Subtyped on Pericardial Fluid Cytology

Deepthi Surendran Pillai

Department of Pathology, Amrita Institute of Medical Sciences, Kochi, India.

Archana George Vallonthaiel *

Department of Pathology, Amrita Institute of Medical Sciences, Kochi, India.

Ajit Nambiar

Department of Pathology, Amrita Institute of Medical Sciences, Kochi, India.

K. Pavithran

Department of Medical Oncology and Hematology, Amrita Institute of Medical Sciences, Kochi, India.

Praveen G. Pai

Department of Cardiology, Amrita Institute of Medical Sciences, Kochi, India.

*Author to whom correspondence should be addressed.

---

Abstract

Primary cardiac lymphoma (PCL) is a very rare malignancy, involving only the heart/pericardium with no or minimal evidence of extra-cardiac involvement.

A 73-year-old lady presented with dyspnea on exertion. Echocardiography revealed a mass predominantly involving the right atrium with moderate pericardial effusion. Pericardiocentesis was done and the smears showed a monomorphic population of medium-sized atypical lymphoid cells. Immunohistochemistry performed on the cellblock was suggestive of Diffuse large B cell lymphoma (DLBCL), activated B cell (ABC) type. PET-MR revealed a metabolically active large diffusely infiltrative intracardiac mass lesion with no other distant possible sites of primary malignancy or extracardiac deposits. Thus, a diagnosis of PCL was made. She underwent a single fraction of palliative radiotherapy as she was unfit for definitive chemotherapy.

Cytological evaluation of pericardial fluid using cell block is a useful and effective tool in the diagnosis as well as subtyping of PCL presenting as malignant effusion.

Keywords: Primary cardiac lymphoma, cytology, cell block, pericardial effusion, diffuse large B cell lymphoma

---

---