A “low and slow” approach to successful medical treatment of primary cardiac lymphoma

Primary cardiac lymphomas (PCL) are very rare lymphoid malignancies that originate from the endocardium or pericardium (1). The clinical diagnosis is often difficult, as they infrequently present with signs and symptoms consistent with other cardiopulmonary conditions. Typically when B symptoms develop, (fever, weight loss, fatigue common in lymphoid malignancies), progressive heart failure will ensue. Antineoplastic treatments used to treat PCL carry the risk of rapid tumor destruction, causing significant cardiovascular complications (2). We present the case of a 62-year-old male who presented with prolonged fatigue and severe right-sided heart failure as a physiologic consequence of PCL. This report highlights the importance of using multiple diagnostic modalities and presents a conservative, patient-specific treatment approach in the management of such cases