Imaging characteristics of cardiac dominant diffuse large B-cell lymphoma demonstrated with MDCT and PET/CT

• Published in: European journal of nuclear medicine and molecular imaging Vol. 40; no. 9; pp. 1337 - 1344
• Main Authors: Kikuchi, Yasuka, Oyama-Manabe, Noriko, Manabe, Osamu, Naya, Masanao, Ito, Yoichi M., Hatanaka, Kanako C., Tsutsui, Hiroyuki, Terae, Satoshi, Tamaki, Nagara, Shirato, Hiroki
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.09.2013; Springer Nature B.V
• Subjects: Adult; Aged; Cardiology; Case-Control Studies; Cells; Child; Coronary Angiography; Electrocardiography; Female; Fluorodeoxyglucose F18; Heart Neoplasms - diagnosis; Heart Neoplasms - diagnostic imaging; Humans; Imaging; Lymphoma; Lymphoma, Large B-Cell, Diffuse - diagnosis; Lymphoma, Large B-Cell, Diffuse - diagnostic imaging; Male; Medical imaging; Medicine; Medicine & Public Health; Middle Aged; Multidetector Computed Tomography; Multimodal Imaging; Nuclear Medicine; Oncology; Original Article; Orthopedics; Pericardial Effusion - diagnosis; Positron-Emission Tomography; Radiology; Radiopharmaceuticals; Tomography, X-Ray Computed; Computed tomography; Coronary CT angiography; Cardiac tumour; PET/CT; Diffuse large B-cell lymphoma
• ISSN: 1619-7070; 1619-7089
• DOI: 10.1007/s00259-013-2436-5

Purpose To investigate the specific imaging findings of multidetector row CT (MDCT) and PET/CT with 18 F-FDG in cardiac dominant diffuse large B-cell lymphoma (DLBCL) in comparison with other cardiac tumours. Methods Five patients with DLBCL and 12 patients with other cardiac tumours including pericardial tumours were retrospectively reviewed. Among the patients with other cardiac tumours, seven had metastatic tumours, three had benign tumours, and two had other malignant cardiac tumours. The location of the cardiac mass, the encasement of the coronary artery surrounded by the mass, and pericardial effusion were evaluated using MDCT. The disease activity of the cardiac tumour was also evaluated by PET/CT. Results Four of the five DLBCL patients had primarily right-sided cardiac lesions, which was seen significantly more frequently in DLBCL than in other cardiac tumours ( p  = 0.028). All cardiac DLBCL lesions were located around the atrioventricular groove and encased the coronary arteries. ECG-gated cardiac MDCT showed that there was no apparent stenosis of the coronary arteries. Large amounts of pericardial effusion were seen in all DLBCL patients. PET/CT revealed significantly higher FDG uptake in DLBCL than in other cardiac malignant tumours, with no overlap ( p  = 0.0007). Conclusion The combination of a right-sided cardiac mass with a large pericardial effusion and no apparent stenosis of the encased coronary artery revealed by MDCT and a high maximum standard uptake value were the specific findings in cardiac dominant DLBCL.