PMC9396226_01
Still image of the apical 4 chamber view shows a severely dilated right ventricle which is larger than the left ventricle with an arrow highlighting a hyperechoic structure extending from the interatrial septum into the left atrium. RV = Right ventricle. RA = Right Atrium. LV = Left Ventricle. LA = Left Atrium.
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fig1
Still image of the patient's plethoric IVC. The IVC was >2.1cm in diameter just distal to the entrance of the hepatic vein and collapsed <50% despite vigorous inspiratory effort by the patient while receiving supplemental oxygen via nasal canula, suggesting elevated right atrial pressures. IVC = Inferior Vena Cava.
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fig2
Histopathological features, stained with hematoxylin and eosin. (a) Low power-pulmonary vessel emboli with hemorrhage, necrotic material, and adipocytes (consistent with a necrotic fat/bone marrow emboli) with adjacent lung parenchyma. (b) High power-necrotic and hemorrhagic material with inflammatory cells and adipocytes (arrow) in a pulmonary vessel.
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fig3
Histologic sections of the lungs revealed multiple emboli of necrotic tissue and adipocytes consistent with necrotic fat/bone marrow emboli (Fig. 3).