Pericardial Diffuse Large B-Cell Lymphoma Diagnosed Via Computed Tomography–Guided Biopsy

Q4 Medicine

JACC. Case reports Pub Date : 2025-09-24 DOI:10.1016/j.jaccas.2025.105070

Toshiya Yoshida MD , Midori Nanamatsu MD , Shunichi Asano MD , Takuya Narita MD, PhD , Miki Terauchi MD , Akira Hirasawa MD, PhD , Yukio Kakuta MD, PhD , Kazuhiko Yumoto MD, PhD

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Abstract

Background

Primary pericardial lymphomas are rare. We describe a case of pericardial diffuse large B-cell lymphoma (DLBCL) diagnosed via computed tomography (CT)–guided biopsy.

Case Summary

A 57-year-old man presented with chest pain and weight loss for 1 month. Multiple diagnostic modalities revealed a pericardial mass with effusion. Pericardiocentesis was performed, and cytology suggested malignant lymphoma; however, the procedure was complicated by pneumothorax owing to mediastinal distortion from the pectus excavatum and minimal effusion. After multidisciplinary discussion, CT-guided biopsy was performed, which confirmed DLBCL. Polatuzumab vedotin, rituximab/cyclophosphamide, doxorubicin, and prednisone were initiated, resulting in tumor shrinkage.

Discussion

Early histopathological diagnosis is essential for treating malignant lymphoma. In this case, CT-guided biopsy was selected as the safest and most effective approach and was successfully performed without complications.

Take-Home Messages

A multidisciplinary approach is necessary for early diagnosis of pericardial lymphoma. CT-guided biopsy can be effective in certain cases.

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心包弥漫性大b细胞淋巴瘤的计算机断层引导活检诊断

背景：原发性心包淋巴瘤是罕见的。我们报告一例心包弥漫性大b细胞淋巴瘤（DLBCL）通过计算机断层扫描（CT）引导活检诊断。病例总结男性，57岁，以胸痛、体重减轻1个月为主诉。多重诊断显示心包肿块伴积液。行心包穿刺，细胞学提示恶性淋巴瘤；然而，由于漏斗胸纵隔扭曲和少量积液导致气胸，手术变得复杂。多学科讨论后，行ct引导活检，确诊为DLBCL。开始使用Polatuzumab vedotin、利妥昔单抗/环磷酰胺、阿霉素和强的松，导致肿瘤缩小。讨论早期病理诊断对恶性淋巴瘤的治疗至关重要。在本例中，ct引导活检被认为是最安全、最有效的方法，并成功地进行了手术，无并发症。心包淋巴瘤的早期诊断需要多学科联合治疗。ct引导下的活检在某些情况下是有效的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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