Pericarditis constrictiva and high-degree atrioventricular block as a first manifestation of a cardiac B-cell lymphoma.
Primary cardiac lymphoma is an extremely rare extranodal non-Hodgkin's lymphoma, exclusively located in the heart and/or the pericardium with no evidence of extracardiac dissemination. In this report, we describe a cardiac B-cell lymphoma arising in a 70-year-old woman who presented to the hospital with heart failure symptoms and a high-degree atrioventricular block of unknown origin. Echocardiography revealed a massive infiltrative thickening of the atrial septum, the aortic root, and the pericardium. Pulsed wave and Doppler tissue findings were highly suggestive for pericarditis constrictiva. Positron emission tomography showed unusually strong metabolic activity in the atrial septum, both atria, and the entire pericardium. Suggested malignoma was confirmed by the pericardial biopsy specimens, which revealed a high-grade diffuse CD20+ B-cell lymphoma.