PMC7360869_01
Cardiomegaly in chest X-ray (posterior-anterior view)
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F1
A 73-year-old man with a history of controlled hypertension and progressive dyspnea of 3 months' duration (New York Heart Association functional class II) and recent nonproductive coughs referred with the water-bottle heart sign in his chest X-ray, suggesting pericardial effusion (Figure 1).
Severe pericardial effusion (orange arrow) and a large mass (blue arrow) anterior to the right ventricular outflow tract in the parasternal long-axis view in 2D transthoracic echocardiography
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F2
A 2D transthoracic echocardiographic examination showed severe circumferential pericardial effusion up to 25 mm anterior to the right ventricular outflow tract without right atrial and right ventricular collapse (Figure 2 & Video 1).
Coronal view of the mediastinal mass (orange arrow) in multislice spiral thoracic computed tomography scan with contrast
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F3
The mass was an intrapericardial lesion adjacent to the right atrium and had an extension toward the right ventricular outflow tract and the base of the ascending aorta (Figure 3).
Gross appearance of the pericardial mass in the operating room after total resection
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F4
A large mass, 13 cm in the greatest dimension, was discovered (Figure 4).
High-power view of the tumor with slightly pleomorphic neoplastic thymic epithelial cells and scattered lymphocytes (Hematoxylin & Eosin stain, x 400)
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F5
Small-sized vessels were present, some surrounded by a clear space containing lymphocytes and proteinaceous material (Figure 5).