A Rare Case of Primary Cardiac T-cell Lymphoma in Immunocompetent Adult

Abstract Introduction/Objective Primary cardiac lymphoma (PCL) is an extranodal involving only the heart and/or pericardium. It exceedingly rare, accounting for <2% of primary neoplasms in a surgical series and 0.05% >12,000 autopsies’ series, often associated with immunocompromised state. Most PCL are B- cell lineage T-cell constituting < 10%. Methods/Case Report We report case unexpected sudden death due to 48-year-old immunocompetent man without significant medical history who presented cardiopulmonary arrest following two-week cold-like symptoms. Autopsy revealed irregular, discontinuous tan plaque on epicardial surface that extended over right left ventricles, sectioning extension lesion throughout subvalvular myocardium ventricular wall, interventricular septum, medial aspects ventricle. The had irregular areas necrosis hemorrhage. No lymphadenopathy or other visceral lesions were identified. Histologically, regionally necrotic, angiocentric infiltrate atypical, large, pleomorphic lymphoid cells nuclei, vesicular chromatin, conspicuous nucleoli. Initial immunohistochemical work-up showed profile CD45+/CD20-/CD3+ suggesting origin CD8 predominance (CD4-/CD8+). Further demonstrated as CD2+/CD7+/CD25+/CD30+/EBV(EBER- ISH)+/Ki67(70-80%)/ ALK-1-/BCL6-/CD5-/CD10-/CD56-, supporting NK/T-cell lymphoma, extranasal type cytotoxic subtype (perforin+/granzyme B+/TIA-1+/TCR Beta F1+). Results (if Case Study enter NA) NA. Conclusion extremely rare fatal. This third past two decades, our knowledge, leading acute failure adult.