PMC5851018_01
Two-dimensional TTE shows pericardial effusion in apical 4-chamber view.
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fig1
The echo also revealed a fibrinous material and stranding suggestive of adhesions in the collection (Figure 1).
Hematoxylin and eosin stains of pericardium at 200x magnification (a) and at 400x magnification (b, c) demonstrate tumor cells with irregular nuclei arranged as interconnecting vascular space. Immunohistochemistry with positive staining for CD31 at 200x magnification confirms vascular differentiation (d).
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fig2
CDX2, BerEp4, calretinin, podoplanin D2, CD45, and S100 (Figures 2-2). These findings led to the diagnosis of epithelioid angiosarcoma of the pericardium. Chest computed tomography scan showed nodular opacifications within both lungs with concern for metastasis.