Primary Cardiac B-Cell Lymphoma

A 67-year-old woman was admitted to a hospital because of the recent onset of general malaise. She had a classic lilac-colored rash over her eyelids, the bridge of her nose, her cheeks, elbows, and knees and weakness in the proximal limb muscles. A diagnosis of dermatomyositis was confirmed by skeletal muscle biopsy. She was started on a course of oral glucocorticoids. Three months later, she complained of dyspnea. An echocardiogram revealed a massive pericardial effusion with evidence of both right atrial and ventricular collapse consistent with cardiac tamponade. Pericardiocentesis yielded 1000 mL of exudative bloody fluid with a lactate dehydrogenase value of 23 950 IU/L. Cytology revealed cells believed to represent lymphoma.The patient was referred to Fukui Medical School for …