Pulmonary tumor embolism from primary cardiac B-cell lymphoma

We report the case of a 54-year-old man with pulmonary embolism during conv alescence from "idiopathic" pericarditis. A transthoracic echocardiographic examination indicated a large mass within the right atrium. Subsequently, he died from refractory hypotension. On autopsy, two large whitish nodules were found in the right atrium; there was also nodular epicardial infiltrat ion. Both lungs showed multiple, grossly visible tumor emboli with pulmonar y infarction and no evidence of conventional thromboembolism, This is the f irst report of pulmonary tumor embolism due to large cell B-cell primary ca rdiac lymphoma. Refractory unexplained pericardial effusion, pulmonary embo lism without risk factors for venous thrombosis, and/or the existence of a mass in the right heart should arouse clinical suspicion for this rare mali gnancy.