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American Journal of Case Reports is ranked the World leading among journals dedicated to publishing clinical case reports. AJCR is indexed in Web of Science, PubMed/ PMC, Scopus

(1) CiteScore (Impact Factor - like by Scopus, Elsevier) is the number of citations received by a journal in one year to documents published in the three previous years, divided by the number of documents indexed in Scopus published in those same three years.

(2) SNIP (Source Normalized Impact per Paper) measures a source’s contextual citation impact by weighting citations based on the total number of citations in a subject field. It helps you make a direct comparison of sources in different subject fields. SNIP takes into account the characteristics of the source's subject field, which is the set of documents citing that source.

(3) SJR is weighted by the prestige of a journal. Subject field, quality, and reputation of the journal have a direct effect on the value of a citation. SJR assigns relative scores to all of the sources in a citation network. Its methodology is inspired by the Google PageRank algorithm, in that not all citations are equal. A source transfers its own 'prestige', or status, to another source through the act of citing it. A citation from a source with a relatively high SJR is worth more than a citation from a source with a lower SJR. 

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Clinical case reports are an invaluable first-hand source of evidence in medicine and a tool most often used in practice to exchange information and generate a more expanded search for evidence. In addition to the “evidence of what happened”, single or multiple cases are an important basis for further and more advanced research on diagnosis, treatment effectiveness, causes and outcomes of disease. However limited their conclusions may be, case reports remain a fundamental component of medicine, contributing greatly to the advancement of health care. In today's ever-expanding Evidence-Based Medicine, case reporting require a well-defined focus, content, and structure.

Presently, only a fraction of case reports is useful for clinical decision-making and bedside-decision oriented research. Therefore, the aim of the Journal is to gather case reports across medical disciplines, thereby integrating interdisciplinary, international medical knowledge.


Published: 2019-12-06

A Rare Case of Diffuse Large B Cell Lymphoma Presenting as a Cardiac Mass

Patrick Yousif, Aditya Kotecha, Ajit Thakur, Hassan M. Ismail

(Department of Internal Medicine, Detroit Medical Center/Wayne State University, Detroit, MI, USA)

Am J Case Rep 2019; 20:1821-1825

DOI: 10.12659/AJCR.917159


BACKGROUND: Primary mediastinal diffuse large B cell lymphoma (DLBCL) presenting as a large intracardiac tumor is extremely rare and has not been significantly reported in the literature. Cardiac lymphoma consists of 2 subtypes: mediastinal DLBCL invading the heart and primary cardiac lymphoma. Both subtypes have a poor prognosis and are treated similarly. Mediastinal DLBCL is a life-threatening condition that, if diagnosed early, has a better survival rate. This is a rare case of a mediastinal DLBCL invading the right atrium as a large intracardiac mass, causing partial obstruction of the tricuspid valve without hemodynamic compromise.
CASE REPORT: A 57-year-old female presented with unintentional weight loss, fatigue, exertional dyspnea, and cough for 8 weeks. Transesophageal echocardiogram showed a mass (3.5×3.5 cm) in the posterior wall of the right atrium partially obstructing the tricuspid valve. Biopsy revealed DLBCL. Given new-onset lymphoma, a human immunodeficiency virus (HIV) test was done and came back positive. CD4 count was 100 cells/mm³. Chemotherapy was initiated with rituximab, cyclophosphamide, epirubicin, vincristine, and prednisone (R-CHOP). Highly active anti-retroviral (HAART) therapy was started for HIV. After treatment with R-CHOP and HAART, the patient had complete resolution of the mass and symptoms on follow-up imaging and evaluation at 6 months.
CONCLUSIONS: Mediastinal DLBCL invading the heart is a life-threatening form of non-Hodgkin’s lymphoma (NHL) and early diagnosis and treatment is critical as prognosis is poor especially if diagnosed in later stages of the disease. Testing for HIV is important as 5% of HIV patients are susceptible to developing NHL.

Keywords: Lymphoma, AIDS-Related, Lymphoma, B-Cell, Lymphoma, Large B-Cell, Diffuse



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