Primary Lymphoma of the Heart

Apreviously healthy 65-year-old woman presented with palpitations and positional chest discomfort 3 weeks after she sustained chest wall trauma in a motor vehicle accident. Physical examination revealed occasional premature ventricular beats and low-grade fever. Her erythrocyte sedimentation rate was elevated (66 mm/h). Transthoracic and transesophageal echocardiography revealed a 3×3-cm, well-demarcated, homogeneous, round mass moving with the heart adjacent to the right atrium (Figures 1A, B). There was invagination of nearby cardiac chambers but no obstruction to right heart filling. MRI showed a circumscribed mass with dense tissue characterization (isointense to myocardium) not consistent with blood or fat (Figure 2A). There was minimal enhancement of the mass after gadolinium injection. Coronary angiography was normal. Two weeks later, …