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Case report: multimodality imaging to diagnose cardiac diffuse large B-cell lymphoma. Background: Primary cardiac lymphoma (PCL) is rare and can present with a wide variety of clinical symptoms, frequently leading to a delay in diagnosis. Case summary: We report a case of a PCL in an 81-year-old man. Cardiac magnetic resonance imaging showed multiple masses in the right atrium and a mass in the right ventricular outflow tract extending to the pulmonary artery. Biopsy revealed a diffuse large B-cell lymphoma. The patient also had metastases to the liver and lung on the positron emission tomography-computed tomography (PET-CT) scan. He was treated with R-CHOP chemotherapy, with complete remission documented PET-CT scans. Conclusion: Although most patients with PCL die before chemotherapy can be initiated, a timely diagnosis can result in a favourable outcome.