case_images: PMC10925652_01
case_images: Admission electrocardiogram (A) showing a sinus rhythm with low voltage in the chest leads and right bundle branch block. Chest X-ray (B) indicating an enlarged heart shadow. Chest CT (C) suggesting a large volume of effusions in the pericardial cavity.
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case_images: The admission electrocardiogram showed a sinus rhythm with low voltage in the chest leads and right bundle branch block ( Figure 1 ).
case_images: Systemic PET-CT (A-D) showing no clear signs of malignant tumor. The pericardium was slightly thickened and adhered, the metabolism increased slightly, and a small amount of effusions were observed in the pericardium with encapsulated changes.
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case_images: Perfect PET-CT examination revealed no signs of malignant tumor but showed a slight pericardial thickening and adhesive and a small amount of pericardial effusions with encapsulated changes ( Figure 2 ).
case_images: The T2WI fat suppression sequence in (A) showed pericardial thickening, adhesive, and lesions on the right ventricular margin adhering to the pleura. The cardiac movie sequence in (C) revealed that the fibrous pericardium of the right ventricular free wall adhered to the pleura, the serous pericardium was slightly thickened, and a small amount of pericardial effusions were observed. The LGE images of the two-chamber and four-chamber heart in (B, D) indicated thickening and enhancement of the fibrous pericardium.
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case_images: The late gadolinium contrast agent enhancement (LGE) medium implied that the pericardial thickening exhibited delayed enhancement ( Figure 3 ).
case_images: (Wax mass of pericardial effusion) HE morphology and immunohistochemical results consistent with malignant mesothelioma.
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case_images: Figure 4 ). The patient was then transferred to the department of oncology, but the patient refused chemotherapy. For nearly a year and a half, the patient was followed up regularly.