Hodgkin’s Lymphoma Transformation into Diffuse Large B Cell Lymphoma Presented as a Right Atrial Mass: A Case Report

Abstract

Cardiac involvement can occur in lymphoma, with the right heart being predominantly affected. The prognosis for patients with cardiac involvement is poor. A 28-year-old man, with a 4-year history of Hodgkin’s lymphoma, presented with progressive shortness of breath and ascites. Chest X-ray (CXR) and CT scan revealed multiple masses in the mediastinum. To exclude a pulmonary embolism, the patient underwent CT angiography, which incidentally revealed a filling defect in the right atrium. Trans-esophageal echocardiography confirmed the presence of a mass in the right atrium. Surgery was performed to obtain samples of the mediastinal masses and the right atrium mass. Pathological results indicated that the nature of the right atrium mass was diffuse large B-cell lymphoma (DLBCL), suggesting that the Hodgkin’s lymphoma had transformed into DLBCL. The transformation of Hodgkin’s lymphoma to DLBCL can occur, and cardiac involvement is not common. Given that the transformation of Hodgkin’s lymphoma into DLBCL can occur many years after the initial diagnosis, the authors recommend follow- up of these patients, as the prognosis may be worse than for non-transformed subtypes.

Keywords

• Hodgkin’s lymphoma
• large B cell lymphoma
• Transformation
• Right atrial mass