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Case Report Open Access

Cardiac mass in a patient with HIV infection: A case report and literature review

  • Authors:
    • Adrian Gradinaru
    • Andrei Colita
    • Ionela Muraretu
    • Mircea Bajdechi
    • Anca Mihailescu
    • Carmen Saguna
    • Radoi Roxana
    • Adriana-Luminita Gurghean
  • View Affiliations / Copyright

    Affiliations: Department of Medical Semiology, Coltea Clinical Hospital, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest 050474, Romania, Department of Hematology, Coltea Clinical Hospital, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest 050474, Romania, Faculty of Medicine, Ovidius University of Constanta, Constanta 900470, Romania, First Department, Infectious Diseases, Dr. Victor Babes Clinical Hospital of Infectious and Tropical Diseases, Bucharest 030303, Romania
    Copyright: © Gradinaru et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
  • Article Number: 51
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    Published online on: December 15, 2025
       https://doi.org/10.3892/etm.2025.13046
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Abstract

Hematological malignancies have multiple complications depending on their type and treatment, ranging from thromboembolic events to myocardial infarction and cardiac metastases. Cardiac masses can be benign or malignant (primary or secondary). When diagnosed, malignant cardiac tumors are usually metastatic in nature and are observed in patients with advanced neoplasia or disseminated disease. Depending on the subgroup of patients, some hematological malignancies have a higher incidence compared with the general population, such as patients living with HIV infection (PLWHIV). In this subgroup of patients, lymphomas, mainly the non‑Hodgkin lymphoma subtypes, including large B‑cell lymphoma and Burkitt lymphoma (BL), are the most frequent malignant tumors identified. These tumors may occur even in PLWHIV with a normal CD4+ cell count and are highly aggressive tumors that, even though not frequently, may lead to cardiac metastases, highlighting the need for a high degree of suspicion, rapid diagnosis and treatment initiation in these patients. The present study encompasses a literature review on cardiac BL and a representative case of a 57‑year‑old man with a history of HIV infection, with a preserved CD4+ cell count, who was diagnosed with BL with secondary cardiac involvement. The rapid growth of the tumor was outlined in sequential echocardiographic evaluations and a multi‑agent chemotherapy regimen was initiated. The treatment was well tolerated, with a notable reduction in the cardiac mass and no cardiovascular complications associated with treatment during monitoring of the patient. A literature review was conducted to identify all the documented cases of adult cardiac BL of the past 15 years, outlining the low prevalence and high risk of these lymphoid tumors and main diagnostic methods, highlighting the importance of early imaging and multidisciplinary management of these rare but life‑threatening cases.
View Figures

Figure 1

Chest X-ray showing left basal
pleural effusion and right upper mediastinum enlargement with
tracheal compression. Scale (horizontal bar), 127.6 mm. R, right
side.

Figure 2

Echocardiography at the initial
evaluation (apical four chamber view) revealing an atrial mass that
infiltrates the roof of the right and left atrium as well as the
right upper pulmonary vein. HR, heart rate.

Figure 3

Echocardiography at the initial
evaluation (modified apical four chamber view) revealing an atrial
mass that occupies 1/3 of the right atrial area and interatrial
septum. HR, heart rate.

Figure 4

Echocardiography at the initial
evaluation (apical three chamber view) showing the atrial mass
extension to the anterior wall of the left atrium, with a
noticeable thickened appearance. HR, heart rate.

Figure 5

Echocardiography bull's-eye plot at
the initial evaluation showing a slightly reduced global strain and
ejection fraction, localized at the level of the basal segments of
the antero-lateral, antero-septal and septal walls and
interventricular septum. SEPT, septal wall; ANT, anterior; LAT,
lateral wall; POST, posterior; INF, inferior; GS, global
longitudinal strain; EF, ejection fraction; AVC, aortic valve
closure; HR, heart rate; APLAX, apical long-axis; PSD, peak strain
dispersion; G peak SL, global peak longitudinal strain.

Figure 6

CT scan showing a cervical mass with
laryngeal compression, with compression and stenosis of the right
(left side of the image) common carotid artery, internal carotid
artery and external carotid artery and apparent extrinsic
obstruction of the right internal jugular vein. Scale (horizontal
bar), 100.4 mm.

Figure 7

CT scan showing a right atrial mass
that infiltrates the left atrium, interatrial septum and right
upper pulmonary vein, surrounding the aortic root. Scale
(horizontal bar), 100.4 mm.

Figure 8

CT scan showing that the right atrial
mass infiltrates the interatrial septum, roof of the right atrium
and upper right pulmonary vein. Scale (horizontal bar), 100.4
mm.

Figure 9

Echocardiography at 1 week after the
initial evaluation (apical four chamber view) revealing that the
atrial mass exhibits an increase in size, infiltrating the roof of
the right atrium, interatrial septum, left atrium and the right
upper pulmonary vein.

Figure 10

Echocardiography at 3 weeks after the
initial evaluation (modified apical four chamber view) revealing
growth of the tumoral mass, infiltrating the right atrial area, the
left atrium and interatrial septum and extending to the base of the
left and right ventricles. HR, heart rate.

Figure 11

Representative histopathology and
immunophenotype supporting the diagnosis of Burkitt lymphoma. (A)
Ki-67 proliferation index of ~98%. (B) CD20 highlights diffuse
B-cell phenotype. (C) Nuclear c-Myc expression in ~70% of tumor
cells(D) Standard H&E staining showing diffuse B-cell
infiltrate with strong basophilia and multiple prominent basophilic
nucleoli, with multiple mitoses [(A-C) magnification, x20; scale
bar, 100 µm; (D) magnification, x40; scale bar, 50 µm].

Figure 12

Echocardiographic apical four chamber
view (5 days after chemotherapy initiation) revealing notable
decrease in size of the tumoral mass is observed, which now
occupies the roof of the right and left atrium and the upper
portion of the interatrial septum. HR, heart rate.

Figure 13

Echocardiographic slightly modified
apical four chamber view made 5 days after chemotherapy initiation
showing a remnant of the tumoral mass, observed at the base of the
interatrial septum; however, it was much smaller in comparison with
the evaluation before chemotherapy initiation. HR, heart rate.

Figure 14

Post-chemotherapy electrocardiogram
showing sinus rhythm, a heart rate of 90 bpm, remission of the
right bundle branch block morphology, remission of the negative T
waves in V2-V3, diffuse QRS microvoltage (showing in this case loss
of electrical signal caused probably by tumoral infiltration)and
normalization of the corrected QT interval (435 msec, Fridericia
formula). V1-V6 refer to precordial leads. aVR, augmented vector
right; aVL, augmented vector left; aVF, augmented vector foot; LP,
low pass; AC, alternating current.

Figure 15

Echocardiography bull's-eye plot
recorded after 3 cycles of chemotherapy showing slightly reduced
GS, with minimal dyskinesia localized at the level of the basal
segments of the antero-lateral, antero-septal, septal and lateral
walls and preserved ejection fraction. SEPT, septal wall; ANT,
anterior; LAT, lateral wall; POST, posterior; INF, inferior; GS,
global longitudinal strain; EF, ejection fraction; AVC, aortic
valve closure; HR, heart rate; APLAX, apical long-axis; PSD, peak
strain dispersion; G peak SL, global peak longitudinal strain.
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Copy and paste a formatted citation
Spandidos Publications style
Gradinaru A, Colita A, Muraretu I, Bajdechi M, Mihailescu A, Saguna C, Roxana R and Gurghean A: Cardiac mass in a patient with HIV infection: A case report and literature review. Exp Ther Med 31: 51, 2026.
APA
Gradinaru, A., Colita, A., Muraretu, I., Bajdechi, M., Mihailescu, A., Saguna, C. ... Gurghean, A. (2026). Cardiac mass in a patient with HIV infection: A case report and literature review. Experimental and Therapeutic Medicine, 31, 51. https://doi.org/10.3892/etm.2025.13046
MLA
Gradinaru, A., Colita, A., Muraretu, I., Bajdechi, M., Mihailescu, A., Saguna, C., Roxana, R., Gurghean, A."Cardiac mass in a patient with HIV infection: A case report and literature review". Experimental and Therapeutic Medicine 31.2 (2026): 51.
Chicago
Gradinaru, A., Colita, A., Muraretu, I., Bajdechi, M., Mihailescu, A., Saguna, C., Roxana, R., Gurghean, A."Cardiac mass in a patient with HIV infection: A case report and literature review". Experimental and Therapeutic Medicine 31, no. 2 (2026): 51. https://doi.org/10.3892/etm.2025.13046
Copy and paste a formatted citation
x
Spandidos Publications style
Gradinaru A, Colita A, Muraretu I, Bajdechi M, Mihailescu A, Saguna C, Roxana R and Gurghean A: Cardiac mass in a patient with HIV infection: A case report and literature review. Exp Ther Med 31: 51, 2026.
APA
Gradinaru, A., Colita, A., Muraretu, I., Bajdechi, M., Mihailescu, A., Saguna, C. ... Gurghean, A. (2026). Cardiac mass in a patient with HIV infection: A case report and literature review. Experimental and Therapeutic Medicine, 31, 51. https://doi.org/10.3892/etm.2025.13046
MLA
Gradinaru, A., Colita, A., Muraretu, I., Bajdechi, M., Mihailescu, A., Saguna, C., Roxana, R., Gurghean, A."Cardiac mass in a patient with HIV infection: A case report and literature review". Experimental and Therapeutic Medicine 31.2 (2026): 51.
Chicago
Gradinaru, A., Colita, A., Muraretu, I., Bajdechi, M., Mihailescu, A., Saguna, C., Roxana, R., Gurghean, A."Cardiac mass in a patient with HIV infection: A case report and literature review". Experimental and Therapeutic Medicine 31, no. 2 (2026): 51. https://doi.org/10.3892/etm.2025.13046
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