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Malignant Lymphoma Invading Visceral Pericardium
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Malignant Lymphoma Invading Visceral Pericardium

View of posterior wall of heart with inferior border facing the lower corner on your right.
The middle band of fat from base to apex separating the visible ventricular red brown surface into 2 areas marks the posterior aspect of the IV septum with the RV above and the LV below.
Note the white lymphoma involving the surface of the atriums (arrow), and possibly the deeper myocardium. Cancers do not respect anatomical layers.
(Description By:Melinda Sanders,M.D. )
(Image Contrib. by:Melinda Sanders,M.D. UCHC )
Lymphoma
Etiology

Unknown
Pathogenesis

Theoretically, the result of a mutated neoplastic lymphocyte proliferating as a clone; some are associated with specific translocations.
Possible occurrence in immunosuppressed persons.,
Epidemiology

The heart is involved by metastatic cancers and lymphomas in 5-10% of cases.
Primary lymphomas of the heart (without involvement of lymph nodes or other organs) are rare.
General Gross Description

May involve any and all layers of the heart and any and all chambers of the heart.
A mass thickening or distortion of the shape of involved anatomy.
The cut surface appears either white or shades of gray to light tan, depending on cytological features.
Tumor cells with sparse cytoplasm appear white; other shades vary with amount and features of cytoplasm.
General Microscopic Description

The histology is that of the spectrum of Hodgkins disease and non-Hodgkins lymphomas.
Clinical Correlation

Arrhythmias are the most common sign of cardiac involvement, as with any metastatic cancers.
Visceral and/or parietal pericardial involvement cause effusions which are usually hemorrhagic.
Impaired cardiac output possible due to restrictive myocardial infiltration.
Mass lesions causing obstruction of blood flow are rare.
References

Cotran RS, Kumar V, Robbins SL: Robbins Pathologic Basis of Disease. 5th edition. Philadelphia, W.B. Saunders, 1994, pp. 569-571 and 633-666.
Lymphoma
Synopsis by: J. Hasson, MD (T31000M95903)[300]
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