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(A) X-ray of the patient showing cardiomegaly, (B) Echocardiogram showing pericardial fluid, (C) Tea-colored pericardial aspirate.
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An 18-year-old male was referred to our hospital for asymptomatic cardiomegaly (Fig. 1A). Echocardiography revealed massive pericardial effusion without tamponade (Fig. 1B). Pericardiocentesis yielded 1.25 L of tea-colored fluid (Fig. 1C).
(A) Lymphoscintigraphy showing Tc99 radioactivity around the heart, (B) Fusion MRI and scintigraphy image showing seepage of Tc99 in the pericardial space, (C) Photomicrograph of the histology of lymphangioma pericardium showing lymphoid follicles (arrow) and cystic spaces.
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Lymphoscintigraphy using 99Tc demonstrated lymphatic leak around the heart region (Fig. 2A). Fusion of MRI images with lymphoscintigraphy was taken with a view of localizing the leak site; it demonstrated enhancement in the pericardial space (Fig. 2B). Pericardial biopsy showed cystic lymphangioma of pericardium (Fig. 2C).
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