Complete atrio-ventricular block as a major clinical presentation of the primary cardiac lymphoma: a case report

It is uncommon for malignant lymphomas to present primarily with cardiac in vasion as the main clinical feature. What we are interested in is not only where the disease is, but also those symptoms that it may induce. Sudden on set of complete atrio-ventricular block is one of the most common clinical presentations. Cardiac tamponade is another common disease entity which, if it locates over outlets of great vessels, may also exert symptoms of obstr uctive vessels. Diagnosis can be made by needle aspiration under the guidan ce of transcutaneous or transesophageal echocardiography. Both CT scan and MRI play positive roles in the diagnosis of cardiac lymphomas, and the latt er can even provide much more image information than the former. We report a 70-year-old male with primary cardiac lymphoma with initial clinical pict ures of sudden onset of complete atrio-ventricular block. Chemotherapy was utilized with cyclophosphamide, vincristine and prednisolone (COP) initiall y for four courses and followed by adding doxorubicin (CHOP) for another th ree courses. The patient was still in remission status after treatment for 2 years.