PMC5149636_01
Transthoracic echocardiography demonstrates a large pericardial effusion ((a) apical 4-chamber view and (b) parasternal short axis view) and chest CT shows a large pericardial effusion, bilateral pleural effusions, and atelectasis of the left lower lobe (c).
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Echocardiography demonstrated a large pericardial effusion (Figures 1(a) and 1(b)) with collapse of the right atrium and ventricle as well as classical hemodynamic changes, typical of tamponade. Computed tomography (CT) of the chest and abdomen was normal except for pericardial and bilateral pleural effusions and left lower lobe atelectasis (Figure 1(c)).
Histological examination of pericardium. The tumor cells are large polygonal cells with prominent nuclei and cytoplasmic vacuoles (Hematoxylin and Eosin staining, x40) (a). Strong diffuse staining of mesothelioma cells with Cytokeratin 5/6 (x10) (b). Calretinin staining is strongly positive in tumor cells (x10) (c).
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Tumor foci were also detected on histological examination of mediastinal fat (Figures 2(a), 2(b), and 2(c)).