Author + information
- Received September 14, 2009
- Accepted September 24, 2009
- Published online March 30, 2010.
- Justin A. Mariani, MBBS, PhD⁎,†,
- Mark A. Dawson, MBBS‡,
- Sharon Avery, MBBS‡ and
- Andrew J. Taylor, MBBS, PhD⁎,†
A previously well, immunocompetent 76-year-old woman with syncope and dyspnea was referred after a chest computed tomography examination detected a right atrioventricular (AoV) mass. Transesophageal echocardiography (A and B) demonstrated a large nonspecific mass involving the right heart. Subsequent subxiphisternal biopsy confirmed a diffuse large B-cell lymphoma. Positron emission tomography confirmed cardiac isolation. Cardiac magnetic resonance (CMR) imaging (C and D) gradient echo (bright-blood) cine sequences demonstrated encroachment of the mass into the right heart (white arrows), including a pedunculated segment within the right atrium (RA) (black arrow). There was evidence of lymphomatous encirclement of the ascending aorta (G to I), with the right coronary artery seen traversing through the malignancy (I, white arrow). Tagged CMR imaging sequences demonstrated cardiac musculature integrity before chemotherapy. Follow-up CMR images (E and F) obtained 6 months after aggressive chemotherapy (CHOP-14 plus rituximab) revealed successful treatment but persistent right ventricular (RV) dilation. At 5 years, the patient remains in remission and without heart failure.
- Received September 14, 2009.
- Accepted September 24, 2009.
- American College of Cardiology Foundation