TRANSESOPHAGEAL ECHOCARDIOGRAPHY-GUIDED B IOPSY OF INTRACARDIAC MASSES OF AN HIGH MALIGNANT NON-HODGKIN-LYMPHOMA OF THE HEART INTRA VITAM

We report about a 66-year old patient with Non-Q-wave infarction in co ronary artery two-vessel disease. During an echo-and transesophageal m ultiplane echocardiography preoperatively before a coronary artery byp ass surgery a right atrium septal tumor of unknown form was discovered . The computerized axial tomography (CAT) and nuclear magnetic resonan ce (NMR) scans did not demonstrate extracardiac pathologic findings. A transesophageal echocardiography-guided biopsy of the right atrial se ptum over the vena femoralis and the light atrium enabled intra vitam a very early diagnosis of high malignant B-fell Non-Hodgkin-lymphoma w ithout the need for thoracotomy. The diagnosis was confirmed histopath ologically and immunhistochemically and early treatment with cytostati c therapy could begin. To our knowledge the transesophageal echocardio graphy biopsy has never been described in the worldwide literature.