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Fluorescence in situ hybridisation testing demonstrated MYC and BCL6 rearrangements without BCL2 gene rearrangement. The overall morphological, immunohistochemical and cytogenetic findings supported a diagnosis of high-grade B cell lymphoma with MYC and BCL6 rearrangements. After extensive staging workup, localised disease involving the pericardium with a diagnosis of primary cardiac large B cell lymphoma was established. She was treated with dose-adjusted etoposide, prednisone, vincristine, cyclophosphamide, doxorubicin and rituximab chemotherapy. Rituximab was discontinued owing to largely absent CD20 expression. Interim positron emission tomography-CT after three cycles revealed a complete response, and the patient completed six cycles of therapy.<\/jats:p>","DOI":"10.1136\/bcr-2023-256167","type":"journal-article","created":{"date-parts":[[2023,12,27]],"date-time":"2023-12-27T03:00:30Z","timestamp":1703646030000},"page":"e256167","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Primary cardiac large B cell lymphoma"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9689-9978","authenticated-orcid":false,"given":"Sumukh","family":"Arun Kumar","sequence":"first","affiliation":[{"name":"Internal Medicine, Saint Vincent Hospital, Worcester, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rahul","family":"Mishra","sequence":"additional","affiliation":[{"name":"Internal Medicine, Anne Arundel Medical Center, Annapolis, Maryland, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarat Chandra","family":"Malempati","sequence":"additional","affiliation":[{"name":"Internal Medicine, Saint Vincent Hospital, Worcester, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Poorva","family":"Bindal","sequence":"additional","affiliation":[{"name":"Division of Hematology\/Oncology, UMass Chan Medical School, Worcester, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2023,12,26]]},"reference":[{"key":"2025082623132718000_16.12.e256167.1","unstructured":"Burke AP , Virmani R . 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