A case of primary cardiac B cell lymphoma associated with ventricular tachycardia, successfully treated with systemic chemotherapy and radiotherapy -A long-term survival case

We experienced a long-term survival case of primary cardiac lymphoma (PCL) demonstrating ventricular tachycardia (VT) as an initial sign, which was re lated to localized myocardial damage by lymphoma cells. A 70-year-old woman with sustained VT was admitted to the Kofu Municipal Hospital. VT ceased w ith the administration of disopyramide intravenously. The origin of the VT was the free wall of the right ventricular outflow tract (RVOT) as observed by electrocardiography on admission. A solitary mass in the free wall of t he RVOT was found by echocardiography, chest computed tomographic scanning and magnetic resonance imaging. There was no evidence of extracardiac invol vement. The patient was histologically diagnosed as PCL by endomyocardial b iopsy. Chemotherapy started immediately after the diagnosis and the mass sh owed a marked reduction in size. After 8 cycles of chemotherapy, radiothera py was performed. Pericardial thickness in the free wall of the RVOT develo ped without severe side effects. Complete remission has been maintained for 30 months after the initial diagnosis, and no recurrence and arrhythmias h ave been detected during the follow-up period. It was demonstrated that rap id diagnosis and chemotherapy followed by radiotherapy for PCL achieved bet ter survival.