case_images: PMC6701274_01
case_images: Chest CT scan with IV contrast showing a hyperdense mass within the pericardial space, with infiltration into the myocardium, displacing and compressing adjacent structures.
case_images: CRIONM2019-2641976.001.jpg
case_images: PMC6701274_01_CRIONM2019-2641976.001.jpg
case_images: fig1
case_images: In addition to the mediastinal mass, several hyperdense masses were observed in the right lung (Figure 1).
case_images: Transthoracic echocardiography. (a) Parasternal short axis view showing tumoral infiltration around the aortic root without obstruction of the outflow tract. (b) Apical 4-chamber view showing myocardial infiltration to the interatrial septum and the free wall of the right atrium and ventricle.
case_images: CRIONM2019-2641976.002.jpg
case_images: PMC6701274_01_CRIONM2019-2641976.002.jpg
case_images: fig2
case_images: Afterward, transthoracic echocardiography was performed, reporting pericardial effusion with the presence of a mediastinal mass that compromised all four cardiac cavities, infiltrating both atria and partially obstructing the right atrium (Figure 2).
case_images: (a) Microphotography H&E (20x). In the center, we can observe a blood vessel surrounded by neoplastic cells in two different patterns: cells forming nests and spindle cells fusing with each other. (b) Microphotography H&E (40x). The tumoral cells are shown in detail, with a medium to large size, scant cytoplasm, oval nuclei of vesicular chromatin, prominent nucleolus, and several mitotic figures. (c) Immunochemistry of the CD31 marker: the neoplastic cells' cytoplasm and membrane are positive, while the bronchial epithelium is negative.
case_images: CRIONM2019-2641976.003.jpg
case_images: PMC6701274_01_CRIONM2019-2641976.003.jpg
case_images: fig3
case_images: A biopsy was taken (Figure 3), and, macroscopically, the specimen was a 7 x 4 x 2 cm lung parenchyma, with multiple, well-circumscribed solid brown nodular lesions surrounded by collapsed lung tissue.