대한흉부영상의학회 Korean Society of Thoracic Radiology

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Weekly Chest CasesCases by Disease Category

Case No : 881 Date 2014-09-15

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  • Courtesy of Yun Jung Kim, Yoo Jin Hong / Severance Hospital, Yonsei University College of Medicine
  • Age/Sex 22 / M
  • Chief ComplaintRecurrent pericardial effusion for 4 months
  • Figure 1
  • Figure 2
  • Figure 3
  • Figure 4

Diagnosis With Brief Discussion

Diagnosis
Malignant Pericardial Mesothelioma
Radiologic Findings
Chest PA shows cardiomegaly and small amount of left pleural effusion. Iniital chest CT scan shows small amount of pericardial effusion and left pleural effusion. The 2 months follow up chest CT scan shows increased amount of septated pericardial effusion with heterogeneous enhancing infiltrative soft tissue mass along the pericardium. PET-CT shows infiltrative mass lesions along the pericardium with intensely increased FDG uptake combining with loculated pericardial effusion.

This patient was complained of recurrent pericardial effusion and was diagnosed on pericardial biopsy as pericardial mesothelioma and treated by pericardiectomy with partial resection of the mass under mid-sternotomy and adjuvant chemotherapy.
Brief Review
Primary pericardial tumors are rare and can be benign (teratoma, fibroma, angioma, lipoma) or malignant (mesothelioma, sarcoma). Secondary tumors are more common, metastasizing mostly from the lung, breast, melanomas, lymphoma, or leukemia. The incidence of malignant pericardial involvement has been reported in the literature from 0.15
Please refer to
Case 222, Case 514,
References
1.S Suman, P Schofield, and S Large, Heart. Jan 2004; 90(1): e4.
2.J Montesinos, S Catot, F Sant, et. Al., Mesotheliomas - Synonyms and Definition, Epidemiology, Etiology, Pathogenesis, Cyto-Histopathological Features, Clinic, Diagnosis, Treatment, Prognosis, In Tech, 2012: 40-42.
Keywords
Pericardium, Malignant tumor,

No. of Applicants : 83

▶ Correct Answer : 21/83,  25.3%
  • - The University of Tokyo Hospital , Japan Akifumi Hagiwara
  • - NIMS, HYDERABAD , India bhaskar kakarla
  • - Yokohama-asahi-chuo-general hospital , Japan Kyoko Nagai
  • - Kyoto University , Japan Akihiko Sakata
  • - McGill University Health Center , Canada Alexandre Semionov
  • - Kizawa Memorial Hospital , Japan Yo Kaneko
  • - Samsung medical center , Korea (South) Hyun Su Kim
  • - MBAL BURGAS , Bulgaria VLADISLAV RUSINOV
  • - The University of Tokyo Hospital , Japan Toshihiro Furuta
  • - jaslok hospital & research centre mumbai , India JAINENDRA JAIN
  • - Government Medical College, Nagpur, India , India Krishna Prasad Bellam
  • - The University of Tokyo Hospital , Japan Takeyuki Watadani
  • - Saint Malo , France jean-baptiste Noel
  • - CHU POITIERS , France SZTARK Guillaume
  • - National Center hospital of Neurology and Psychiatry , Japan Kaoru Sumida
  • - Teikyo University Mizonokuchi Hospital , Japan Noriko Kobayashi
  • - IRSA LA ROCHELLE , France, Metropolitan BIGOT
  • - CLCC Rennes , France nicolas gautier
  • - Northern Yokohama Showa university , Japan Kota Watanabe
  • - CLINIQUE STE CLOTILDE , Reunion patrick MASCAREL
  • - CNUH , Korea (South) Kim Soo Hyun
▶ Correct Answer as Differential Diagnosis : 25/83,  30.1%
  • - Oita University, Faculty of Medicine , Japan Fumito Okada
  • - Kyung Hee University Hospital at Gangdong , Korea (South) Seong Jong Yun
  • - Niigata City General Hospital , Japan Takao Kiguchi
  • - Seoul National University Hospital , Korea (South) Sang Min Lee
  • - Royal Perth Hospital , Australia Yuranga Weerakkody
  • - GHICL , France manuel toledano
  • - Ibaraki-gazou-shindan , Japan Shoichi Katoh
  • - Kmc chennai , India chellaraja c
  • - CHU Poitiers , France CHAN paul
  • - Seirei Hamamatsu General Hospital , Japan Kenichi Mizuki
  • - DAYA General Hospital,Thrissur,Kerala , India Raveendran TK
  • - National Hospital Organization Okinawa Hospital , Japan Yasuji Oshiro
  • - Asan Medical Center, Ulsan University , Korea (South) Mi Young Kim
  • - Shiga University of Medical Science , Japan Akitoshi Inoue
  • - chungbuk national university hospital , Korea (South) jeehye kim
  • - ZIGONG TCM HOSPITAL OF CHINA , China Cao Cunyou
  • - Hanyang universitiy, radiology department , Korea (South) HyunGyu Lee
  • - IRSA La Rochelle , France Denis Chabassiere
  • - Nagasaki University Hospital, Department of Pathology , Japan TOMONORI TANAKA
  • - Onomichi municipal hospital , Japan Hirofumi Mifune
  • - Fortis hospital , Mohali , India Shaleen Rana
  • - Gifu Central Hospital , Japan Haruo Watanabe
  • - Pneumologia Universitaria, Policlinico di Bari , Italy Mario Damiani
  • - Medicheck health care , Korea (South) Chae Lim
  • - Onomichi Municipal Hospital , Japan Yoshihisa Masaoka
▶ Semi-Correct Answer : 1/83,  1.2%
  • - Chonnam national university hospital , Korea (South) INSOO JANG
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