PMC9909183_01
(A) Imaging modalities and approaches carried out for the diagnosis of cardiac tamponade. (B) Pericardiocentesis followed by 2D-Echocardiogram revealed a 5 x 4 cm sized mass adjacent to the right atrium. Yellow highlighted area locates the myxoid liposarcoma in the right atrium.
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F1
Moreover, the echocardiogram showed massive pericardial effusion with features suggestive of cardiac tamponade and homogenous mass adjacent to the right atrium (Figures 1A, B).
Lymph node characteristics in the right atrium. (A) CECT thorax revealing minimally enhancing mass lesion in the right atrial wall. (B) Multiple enlarged retroperitoneal lymph nodes. (C) Horizontal sections of FDG PET scan revealing mildly FDG avid hypodensity (5.8 x 5 cm, SUV max -3.40) along the lateral wall of the right atrium with mass effect over it. (D) Coronal section of FDG PET scan revealing mildly FDG avid mass over the lateral wall of the right atrium. (E) Enlarged FDG avid lymph nodes at perivascular, aortocaval, retrocaval, and bilateral common iliac and external iliac levels (F). Yellow highlighted area locates the myxoid liposarcoma in the right atrium. White arrows in (F) indicates metastasis in abdomen areas.
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F2
CECT thorax (Figures 2A, B) revealed minimally enhancing mass lesion in the right atrial wall with a small intraluminal component projecting into the right atrial chamber, with multiple enlarged retroperitoneal lymph nodes. As it was initially suspected to be lymphoma, a PET CT scan (Figures 2C-F) was performed to rule out metastasis, which showed mildly FDG-avid hypodensity along the lateral wall of the right atrium with mass effect over it.
Histopathology observations in right atrial mass (A) biopsy collected from right atrial mass demonstrated signet-ring-shaped lipoblasts in mucoid matrix suggestive of myxoid liposarcoma. (B) The tumor cells are positive for the S100 tumor marker. (C) Schematic illustration of possible risk factors associated with myxoid liposarcomas in the right atrium.
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F3
The findings revealed the presence of myxoid liposarcoma (Figure 3A). The histological findings were further confirmed by tumor markers Pan CK and S100, denoting that the sample stained positive for S100 (Figures 3A, B).