Primary cardiac lymphoma diagnosed by percutaneous intracardiac biopsy with combined fluoroscopic and transesophageal echocardiographic imaging.

Primary cardiac tumors have very low prevalence with cardiac lymphoma, being one of the rarest forms. Several recent reports have shown transesophageal echocardiography to be an accurate technique for characterizing and localizing these neoplasms, with results comparable to CT and MRI scans. Transvenous intracardiac tumor biopsy has been employed as a minimally invasive technique to obtain tissue samples. The addition of transesophageal echocardiographic (TEE) guidance to this process has increased the accuracy of obtaining diagnostic specimens while improving patient safety. We review published cases of this relatively new technique using combined fluoroscopic and TEE guidance and present a case of primary cardiac lymphoma diagnosed by this method. The patient achieved complete tumor remission after treatment with standard chemotherapy and remains fully functional 32 months after initial diagnosis.