Fibrin-associated diffuse large B-cell lymphoma with plasmacytic differentiation: case report and literature review

Diagn Pathol. 2020 Sep 24;15(1):117. doi: 10.1186/s13000-020-01034-7.

Abstract

Background: Primary cardiac lymphomas are extremely rare entities (< 2% of cardiac tumours) and the most frequent histologic type is diffuse large B-cell lymphoma (DLBCL). Fibrin-associated DLBCL (FA-DLBCL) is a very unusual form of DLBCL associated with chronic inflammation, and only case reports and small series have been described. In the heart, it usually occurs in the context of a cardiac myxoma or cardiac prostheses and it is not bulk forming. These lymphomas frequently present with non-germinal center phenotype and are associated with Epstein-Barr virus (EBV) type III latency.

Case presentation: We describe a case of FA-DLBCL arising in a cardiac myxoma, with plasmacytic differentiation and type I EBV latency.

Conclusions: Although they are very rare, FA-DLBCLs should be known for their diagnostic difficulty, due to its unspecified clinical manifestations, and for their more favourable prognosis, sometimes even without additional treatment after surgical resection.

Keywords: Case report; Epstein-Barr virus; Fibrin-associated diffuse large B-cell lymphoma; Myxoma; Primary cardiac lymphoma.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Cell Differentiation / physiology
  • Epstein-Barr Virus Infections / complications*
  • Heart Neoplasms / pathology
  • Herpesvirus 4, Human / genetics
  • Herpesvirus 4, Human / pathogenicity*
  • Humans
  • Inflammation / virology
  • Lymphoma, Large B-Cell, Diffuse / pathology*
  • Myxoma / pathology*
  • Myxoma / virology