Case Report: Primary cardiac diffuse large B-cell lymphoma with sick sinus syndrome and literature review on disease management and therapeutic strategies

BackgroundPrimary cardiac diffuse large B-cell lymphoma (DLBCL) is a rare but clinically challenging extranodal lymphoma. Diagnosis and management are often complicated due to its nonspecific symptoms and rarity.Case ReportWe reported a case of a 73-year-old male who initially presented with chest p...

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Main Authors: Xiaofen Qiu, Li Zhang, Shaojun Zhou, Wenbin Qian, Yun Liang, Huiqing Qiu, Xianggui Yuan
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-07-01
Series:Frontiers in Oncology
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Online Access:https://www.frontiersin.org/articles/10.3389/fonc.2025.1538786/full
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author Xiaofen Qiu
Xiaofen Qiu
Li Zhang
Shaojun Zhou
Wenbin Qian
Wenbin Qian
Yun Liang
Huiqing Qiu
Xianggui Yuan
author_facet Xiaofen Qiu
Xiaofen Qiu
Li Zhang
Shaojun Zhou
Wenbin Qian
Wenbin Qian
Yun Liang
Huiqing Qiu
Xianggui Yuan
author_sort Xiaofen Qiu
collection DOAJ
description BackgroundPrimary cardiac diffuse large B-cell lymphoma (DLBCL) is a rare but clinically challenging extranodal lymphoma. Diagnosis and management are often complicated due to its nonspecific symptoms and rarity.Case ReportWe reported a case of a 73-year-old male who initially presented with chest pain, high fever, dizziness, and amaurosis. Preliminary diagnostic assessments suggested sick sinus syndrome, necessitating the implantation of a dual-chamber pacemaker, and revealed a large mass in the interatrial septum. An endomyocardial biopsy confirmed the diagnosis of primary cardiac DLBCL. Initial treatment with R-miniCHOP chemotherapy yielded a partial response. However, due to treatment-related complications (grade 4 neutropenia and pneumonia), a change in the therapeutic regimen to OR-GemOx chemotherapy was made, leading to complete remission. A year later, the patient experienced a relapse, requiring a salvage treatment of the Pola-BR chemotherapy regimen, which again resulted in complete remission. Additionally, this review examines an in-depth literature review on the management and therapeutic strategies for this entity, focusing on the treatment recommendations for relapse/refractory disease.ConclusionPrompt diagnosis and effective management are crucial in treating primary cardiac DLBCL. While the emergence of new drugs has improved the prognosis by offering higher efficacy and fewer side effects, clinicians should be vigilant about potential cardiotoxicities.
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publisher Frontiers Media S.A.
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spelling doaj-art-d6406a25745148ccbd4f67cee03c2e9c2025-08-20T03:16:07ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2025-07-011510.3389/fonc.2025.15387861538786Case Report: Primary cardiac diffuse large B-cell lymphoma with sick sinus syndrome and literature review on disease management and therapeutic strategiesXiaofen Qiu0Xiaofen Qiu1Li Zhang2Shaojun Zhou3Wenbin Qian4Wenbin Qian5Yun Liang6Huiqing Qiu7Xianggui Yuan8Department of Hematology and Medical Oncology, The Second People’s Hospital of Quzhou, Quzhou, ChinaDepartment of Hematology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, ChinaDepartment of Hematology and Medical Oncology, The Second People’s Hospital of Quzhou, Quzhou, ChinaDepartment of Hematology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, ChinaDepartment of Hematology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, ChinaNational Clinical Research Center for Hematologic Diseases, The First Affiliated Hospital of Soochow University, Suzhou, ChinaDepartment of Hematology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, ChinaDepartment of Hematology and Medical Oncology, The Second People’s Hospital of Quzhou, Quzhou, ChinaDepartment of Hematology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, ChinaBackgroundPrimary cardiac diffuse large B-cell lymphoma (DLBCL) is a rare but clinically challenging extranodal lymphoma. Diagnosis and management are often complicated due to its nonspecific symptoms and rarity.Case ReportWe reported a case of a 73-year-old male who initially presented with chest pain, high fever, dizziness, and amaurosis. Preliminary diagnostic assessments suggested sick sinus syndrome, necessitating the implantation of a dual-chamber pacemaker, and revealed a large mass in the interatrial septum. An endomyocardial biopsy confirmed the diagnosis of primary cardiac DLBCL. Initial treatment with R-miniCHOP chemotherapy yielded a partial response. However, due to treatment-related complications (grade 4 neutropenia and pneumonia), a change in the therapeutic regimen to OR-GemOx chemotherapy was made, leading to complete remission. A year later, the patient experienced a relapse, requiring a salvage treatment of the Pola-BR chemotherapy regimen, which again resulted in complete remission. Additionally, this review examines an in-depth literature review on the management and therapeutic strategies for this entity, focusing on the treatment recommendations for relapse/refractory disease.ConclusionPrompt diagnosis and effective management are crucial in treating primary cardiac DLBCL. While the emergence of new drugs has improved the prognosis by offering higher efficacy and fewer side effects, clinicians should be vigilant about potential cardiotoxicities.https://www.frontiersin.org/articles/10.3389/fonc.2025.1538786/fullprimary cardiac lymphomadiffuse large B-cell lymphomaextranodal lymphomasick sinus syndromeorelabrutinibpolatuzumab vedotin
spellingShingle Xiaofen Qiu
Xiaofen Qiu
Li Zhang
Shaojun Zhou
Wenbin Qian
Wenbin Qian
Yun Liang
Huiqing Qiu
Xianggui Yuan
Case Report: Primary cardiac diffuse large B-cell lymphoma with sick sinus syndrome and literature review on disease management and therapeutic strategies
Frontiers in Oncology
primary cardiac lymphoma
diffuse large B-cell lymphoma
extranodal lymphoma
sick sinus syndrome
orelabrutinib
polatuzumab vedotin
title Case Report: Primary cardiac diffuse large B-cell lymphoma with sick sinus syndrome and literature review on disease management and therapeutic strategies
title_full Case Report: Primary cardiac diffuse large B-cell lymphoma with sick sinus syndrome and literature review on disease management and therapeutic strategies
title_fullStr Case Report: Primary cardiac diffuse large B-cell lymphoma with sick sinus syndrome and literature review on disease management and therapeutic strategies
title_full_unstemmed Case Report: Primary cardiac diffuse large B-cell lymphoma with sick sinus syndrome and literature review on disease management and therapeutic strategies
title_short Case Report: Primary cardiac diffuse large B-cell lymphoma with sick sinus syndrome and literature review on disease management and therapeutic strategies
title_sort case report primary cardiac diffuse large b cell lymphoma with sick sinus syndrome and literature review on disease management and therapeutic strategies
topic primary cardiac lymphoma
diffuse large B-cell lymphoma
extranodal lymphoma
sick sinus syndrome
orelabrutinib
polatuzumab vedotin
url https://www.frontiersin.org/articles/10.3389/fonc.2025.1538786/full
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