{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T09:13:20Z","timestamp":1776417200978,"version":"3.51.2"},"reference-count":10,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T00:00:00Z","timestamp":1773100800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,4,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Primary cardiac lymphoma (PCL) is a rare, aggressive extranodal lymphoma involving the heart and pericardium. It often presents with nonspecific symptoms and conduction disturbance, resulting in diagnostic delay. Multimodal cardiac imaging can characterize PCL tumours and guide biopsy, while histology is required for definitive diagnosis and treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case Summary<\/jats:title>\n                    <jats:p>A man in his 60s with well-controlled HIV presented with recurrent syncope preceded by fever, chest pain, and fatigue. He was found to have profound first-degree atrioventricular block (PR interval 414\u2005ms). Transthoracic echocardiography revealed a large interatrial septal mass protruding into both atria with close association to the aortic root. Cardiac CT, MRI, and FDG PET\u2013CT confirmed a metabolically active mass extending around the peri-aortic structures. Transoesopheal-guided biopsy confirmed PCL of B-cell origin. R-CHOP chemotherapy was commenced with continuous cardiac monitoring. Despite paroxysmal atrial flutter and intermittent higher-grade AV conduction disturbance, permanent pacing was deferred. After two cycles of rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone (R-CHOP), imaging showed substantial tumour regression, reduced FDG avidity, and improved AV conduction (PR 250\u2005ms) and resolution of syncope.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>PCL can present with cardiogenic syncope due to tumour-related involvement of the conduction system and mass effect. This case highlights the value of early multimodal imaging to rapidly characterize cardiac masses and monitor treatment response, while emphasizing the necessity of tissue diagnosis. In selected stable patients, early chemotherapy may reverse tumour-related conduction disease, allowing for deferral of permanent pacemaker implantation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytag185","type":"journal-article","created":{"date-parts":[[2026,3,7]],"date-time":"2026-03-07T12:46:08Z","timestamp":1772887568000},"source":"Crossref","is-referenced-by-count":0,"title":["Primary cardiac lymphoma treated with R-CHOP resulting in rhythm recovery and avoidance of permanent pacing: a case report"],"prefix":"10.1093","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3698-7615","authenticated-orcid":false,"given":"Robert","family":"Ambrogetti","sequence":"first","affiliation":[{"name":"Department of Cardiology, Wycombe Hospital, Buckinghamshire Healthcare NHS Trust , Queen Alexandra Rd, High Wycombe HP11 2TT ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rajaperumal","family":"Ravi","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Wycombe Hospital, Buckinghamshire Healthcare NHS Trust , Queen Alexandra Rd, High Wycombe HP11 2TT ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eaint Kay Khine","family":"Thein","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Wycombe Hospital, Buckinghamshire Healthcare NHS Trust , Queen Alexandra Rd, High Wycombe HP11 2TT ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sina","family":"Fathieh","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Wycombe Hospital, Buckinghamshire Healthcare NHS Trust , Queen Alexandra Rd, High Wycombe HP11 2TT ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3004-9089","authenticated-orcid":false,"given":"Rodney","family":"De Palma","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Wycombe Hospital, Buckinghamshire Healthcare NHS Trust , Queen Alexandra Rd, High Wycombe HP11 2TT ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2026,3,10]]},"reference":[{"key":"2026041704182593400_ytag185-B1","doi-asserted-by":"crossref","first-page":"1509100","DOI":"10.3389\/fonc.2024.1509100","article-title":"Primary cardiac lymphoma: a clinicopathological study of 121 cases","volume":"14","author":"Zhuang","year":"2024","journal-title":"Front Oncol"},{"key":"2026041704182593400_ytag185-B2","doi-asserted-by":"crossref","first-page":"358","DOI":"10.1016\/j.ijcard.2010.02.016","article-title":"Primary cardiac lymphoma","volume":"149","author":"Miguel","year":"2011","journal-title":"Int J Cardiol"},{"key":"2026041704182593400_ytag185-B3","doi-asserted-by":"crossref","first-page":"581","DOI":"10.1002\/cncr.25444","article-title":"Primary cardiac lymphoma","volume":"117","author":"Petrich","year":"2011","journal-title":"Cancer"},{"key":"2026041704182593400_ytag185-B4","doi-asserted-by":"crossref","first-page":"2395","DOI":"10.1161\/CIRCULATIONAHA.115.016418","article-title":"Characteristics and survival of malignant cardiac tumors a 40-year analysis of &gt;500 patients","volume":"132","author":"Oliveira","year":"2015","journal-title":"Circulation"},{"key":"2026041704182593400_ytag185-B5","doi-asserted-by":"crossref","first-page":"1344","DOI":"10.1097\/PAS.0b013e3180317341","article-title":"Primary cardiac lymphoma: clinical, histologic, immunophenotypic, and genotypic features of 5 cases of a rare disorder","volume":"31","author":"Nascimento","year":"2007","journal-title":"Am J Surg Pathol"},{"key":"2026041704182593400_ytag185-B6","doi-asserted-by":"crossref","first-page":"1369","DOI":"10.1148\/rg.325115126","article-title":"From the radiologic pathology archives: cardiac lymphoma: radiologic-pathologic correlation","volume":"32","author":"Jeudy","year":"2012","journal-title":"Radiographics"},{"key":"2026041704182593400_ytag185-B7","doi-asserted-by":"crossref","first-page":"890059","DOI":"10.3389\/fimmu.2022.890059","article-title":"Case report: primary cardiac T-cell lymphoma with complete atrio-ventricular block diagnosed by endomyocardial biopsy","volume":"13","author":"Chen","year":"2022","journal-title":"Front Immunol"},{"key":"2026041704182593400_ytag185-B8","volume-title":"Diagnostics (Basel)","author":"Aggeli","year":"2020"},{"key":"2026041704182593400_ytag185-B9","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1016\/j.jtcvs.2020.09.102","article-title":"Primary cardiac lymphoma","volume":"164","author":"Yin","year":"2022","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2026041704182593400_ytag185-B10","author":"Major"}],"container-title":["European Heart Journal - 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