PMC3618032_01
a A chest CT scan with contrast showing a right atrial mass, a large pericardial effusion and bilateral pleural effusions. b A chest CT scan showing complete resolution of the bilateral pleural effusions 3 weeks after the first dose of combination chemotherapy. c An echocardiogram showing a large pericardial effusion with a large right atrial mass. d An echocardiogram showing complete resolution of the pericardial effusion and a significant decrease in the size of the right atrial mass 3 weeks after the first cycle of combination chemotherapy.
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F1
A CT scan showed mediastinal adenopathy, bilateral pleural effusions, a pericardial effusion and a right atrial mass (fig. 1a). A cardiac echocardiogram showed a right atrial mass and a large pericardial effusion with tamponade physiology (fig. 1c). Subsequent imaging showed resolution of the pleural effusions and a significant decrease in the size of the right atrial mass (fig. 1b, d).
a The hematoxylin and eosin-stained section shows a relatively monomorphous sheet of medium-sized atypical lymphocytes with round nuclei, fine to slightly vesicular chromatin, one or several prominent nucleoli and a moderate amount of slightly vacuolated pink cytoplasm. Mitotic activity is conspicuous (blue arrow). There are scattered necrotic and apoptotic cells (black arrow). b Positive nuclear staining for HHV-8 by immunohistochemistry (some examples of positive nuclei are marked by black arrows). c Cytoplasmic staining for the B cell marker CD20.
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F2
T cell markers was negative. The biopsy of the right atrial mass via transvenous route showed large lymphoblastic cells with positive staining for HHV-8, CD20, CD30 and lambda light chains (fig. 2a, b).