18F-FDG PET/CT features and management of primary cardiac lymphoma: a case report

An 81-year-old man presented with progressive symptoms of heart failure. Echocardiography showed a mass in the right atrium (approximately 31 × 55 mm) that extended to the tricuspid valves as well as the superior vena cava. Positron emission tomography-computed tomography (PET-CT) showed elevated 18F-fluorodeoxyglucose (18F-FDG) uptake throughout the space-occupying lesions. The patient received surgery based on a preliminary diagnosis of myxoma. Pathological examination of the resected specimen revealed large B-cell lymphoma. The patient received three cycles of rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone regimen but no subsequent anti-tumor therapy. At the last follow-up 3.5 years later, he was still alive. In summary, primary cardiac lymphoma should be considered in differential diagnosis in isolated space-occupying lesions in the heart.