case_images: PMC10993256_01
case_images: Computed tomography (CT) images of primary cardiac lymphoma (PCL). Transverse (A) and coronal (B) images revealed multiple nodular and clumped slightly hypodense foci in the heart and pericardium, along with effusions in the pericardium and pleural cavity.
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case_images: PMC10993256_01_fmed-11-1373773-g001.jpg
case_images: fig1
case_images: A chest CT scan disclosed an enlarged and dysmorphic heart, displaying multiple nodular and clumped slightly hypodense foci in the heart and pericardium, along with effusions in the pericardium and pleural cavity (Figures 1A,B).
case_images: Histopathological and immunohistochemical images of PCL. Hematoxylin-eosin (HE) staining (magnification x400) of the lesion (A) revealed microscopic cells characterized by large, deeply stained nuclei, scanty cytoplasm, moderate cellular anisotropy, visible small nucleoli, and distinct nuclear fission images and apoptosis. Immunohistochemical staining (400x) showed tumor cells were positive for the expression of CD5 (B), CD10 (C), CD20 (D), MUM1 (E), and Bcl-2 (F).
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case_images: PMC10993256_01_fmed-11-1373773-g002.jpg
case_images: fig2
case_images: CA125 at 203 U/mL (normal range: 0-35 U/mL), CYFRA21-1 at 5.40 ng/mL (normal range: 0-3.3 ng/mL), and NSE at 17.75 ng/mL (normal range: 0-16.3 ng/mL). Cytologic examination of pericardial and pleural effusions exhibited microscopic cells characterized by large, deeply stained nuclei, scanty cytoplasm, moderate cellular anisotropy, visible small nucleoli, and distinct nuclear fission images and apoptosis (Figure 2A). Immunohistochemical staining demonstrated positive expression of CD5, CD10, CD20, MUM1, and Bcl2 (Figures 2B-F).
case_images: 18F-FDG PET/CT images of PCL. The anteroposterior 3-dimensional maximum intensity projection image (MIP) demonstrated FDG-avid lesions on the heart, pericardium (long arrows) and multiple lymph nodes (dash arrows) (A). Transverse and coronal images showed multiple nodular soft tissue density lesions in the heart and pericardium exhibiting increased FDG metabolism (B). Enlarged lymph nodes were identified in the mediastinum displaying heterogeneous FDG uptake (C). The supradiaphragmatic segments of the inferior vena cava exhibited irregular morphology with localized nodular changes and increased FDG metabolism in the surrounding area (D). Enlarged lymph node was identified in the left axilla displaying heterogeneous FDG uptake (E). Enlarged lymph node was identified near the left kidney displaying heterogeneous FDG uptake (F).
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case_images: PMC10993256_01_fmed-11-1373773-g003.jpg
case_images: fig3
case_images: Additionally, multiple enlarged lymph nodes were identified in the mediastinum, left axilla, and near the left kidney, displaying heterogeneous FDG uptake with an SUVmax of 9.3, indicating lymphoma involvement (Figure 3).