242 PRIMARY CARDIAC LYMPHOMA: A CASE REPORT

Abstract Introduction Primary cardiac lymphomas in immunocompetent patients are an uncommon malignancy, accounting for 1.3% of primary tumors, while metastases secondaries to extracardiac more common. Mean age at diagnosis is 63 years old. They mainly involve the right side heart, particularly atrium. Symptoms lymphoma non-specific. Cardiac typically follows aggressive clinical course and prognosis poor, with than 60% dying within 2 months diagnosis. Predictors worse outcome immune status, left ventricular involvement, arrhythmias presence disease. Case report 48-year-old obese hypertensive man, therapy OSAS. In February 2022 admission emergency department due jugular pressure mild exertion dyspnoea. Neck CT excluded inflammatory collections; echocardiography showed normal cavitary dimensions biventricular systolic function, absence major valvulopathies circumferential pericardial effusion n.d.d. TD max 2.5 cm partial collapse atrium, which started corticosteroid therapy. Chest mediastinal lymphadenopathy persistence effusion. April, worsening dyspnoea, demonstated a solid mass passage from superior vena cava atrium (50×37×67 mm), leading compression-infiltration phenomena on cava, thrombosis mammary vein. MR confirmed voluminous expansive-infiltrative lesion, irregular lobular profile, projecting into extended This appears very iperintensive T2 stir sequences early contrast impregnation uneven intralesional late enhancement (picture 1). With suspicion lymphoma, after collegial discussion between thoracic surgeons, cardiologists, interventional radiologists transjugular radio- echo-guided biopsy was performed complete diagnostic iter; positive peripheral B lymphocyte-derived large-cell diffuse large necrotic subnecrotic areas. Chemotherapy initial benefit,with clear reduction size lymphnodes follow up, regression Conclusions our patient, despite onset typical poor compared literature, diagnostic-therapeutic iter, disease preserved ejection fraction, ensured immediate benefit improvement his quality life.