PMC9024036_01
Transthoracic echocardiogram. (A,B) A hypoechoic mass is seen at the base of the right atrium lateral wall. It is highly mobile and oscillates through the tricuspid valve in diastole. (C) Color Doppler flow imaging in subcostal two-chamber view. (D) Color Doppler flow imaging in four-chamber view).
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F1
A large amount of pericardial effusion was detected (Figures 1A-D).
Myocardial contrast echocardiography images of the mass. (A) After administration of the contrast agent, there is partial enhancement of the mass. (B) After several cardiac cycles, there is an increase in enhancement of the mass.
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F2
After several cardiac cycles, a large amount of scattered ultrasound contrast agent was observed in the right atrial mass (Figures 2A,B).
Computed tomography (CT) images. (A) Arterial phase. The mass was mildly enhanced in the arterial phase. (B) Venous phase. The mass enhancement was reduced in the venous phase.
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F3
Contrast-enhanced computed tomography (CT) revealed a mass near the aortic arch, which was mildly enhanced in the arterial phase (Figure 3A) and reduced in the venous phase (Figure 3B).
The 18F-fluorodeoxyglucose positron emission tomography (PET)/CT scan. (A) A mass in the right atrium with high radiotracer uptake. (B) Whole-body maximum-intensity projection PET images showed high radiotracer uptake in both the right atrium and aorta-ascending para-aorta.
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F4
When evaluating inflammation by positron emission tomography (PET)/CT (Figure 4), masses in the right atrium, the walls of the right atrium and the right ventricle were discovered to be non-homogeneously thickened.
The pathological section revealed diffuse enlargement of lymphocytes. (A) Hematoxylin and eosin staining (x 200). (B) Ki-67 markers (+) (x 100). (C) CD3 markers (-) (x 100). (D) CD20 markers (+) (x 100).
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F5
Finally, a pathological examination of the cell mass in the pericardial effusion (Figure 5) diagnosed it as diffuse large B-cell non-Hodgkin's lymphoma.