Lymphoma deposits represent 13.6% of metastatic tumors to the heart.1 As imaging modalities and treatment options for lymphoma improve, more unusual disease presentations may be observed more frequently.
Lymphomatous involvement of the heart, previously a rarity, is now being reported with greater frequency. Extranodal lymphomas are increasingly seen with acquired immunodeficiencies such as HIV or after bone marrow and solid organ transplantation. The increased incidence might be partly a result of increased clinical awareness, improved imaging techniques, and a change in cellular biology.
Two-dimensional echocardiography is regarded as the primary diagnostic imaging technique for the evaluation of cardiac
masse, with a diagnostic sensitivity of 93% for trans-thoracic echocardiography and 97% for trans-oesophageal
echocardiography. Nuclear medicine techniques previously employed to detect cardiac tumours include blood pool imaging and gallium or thallium scintigraphy . [18F]FDG-PET/CT has been shown to be more accurate than CT in the evaluation of lymphomas and other tumors, especially in the follow-up of patients previously treated with chemotherapy and/or radiotherapy. [18F]FDG-PET/CT may have the advantage of detecting the tumour or metastases at an early stage.
1. Lam KY, Dickens P, Chan AC. Tumors of the heart. A 20-year experience with a review of 12,485 consecutive autopsies. Arch Pathol Lab Med 1993;117:1027–31.
2. A Mallia, LL Travaini, G Trifiro and G Paganelli. Detection of a cardiac mass by [18F]FDG-PET/CT: ecancer 2009, 3:152