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Everything you need to know about Computed Tomography (CT) & CT Scanning


question

Question 6: 50ish yr old male with increasing SOB and dyspnea.What’s the diagnosis?

answer

Diagnosis: Angiosarcoma of the Pericardium

Angiosarcoma of the Pericardium: Facts

  • Most common cardiac sarcoma
  • Most common in middle aged men
  • Most commonly located near right atrial free wall with involvement of pericardium
  • Typically infiltrates pericardium

The Pericardium: Facts

  • Normal thickness under 2 mm
  • 50 ml of fluid is normal
  • Calcification may be a sign of constrictive pericarditis
  • Typically infiltrates pericardium
  • Pericardium is involved in a range of inflammatory and neoplastic processes

Pericardial Tumors: Facts

  • Most often metastatic disease rather than a primary tumor
  • Common primaries include esophageal cancer, thymoma, lung cancer and melanoma
    and breast cancer
  • Lung cancer is most common in males and breast cancer in females
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Primary Cardiac Tumors: Facts

  • Uncommon
  • 75% are benign, 25% are malignant
  • Most malignant cardiac tumors are angiosarcomas
  • Angiosarcomas occur most commonly in the right atrium

Cardiac Tumors: Facts

  • Most common primary cardiac tumor is myxoma
  • Myxomas are most common in the left atrium in or near the foramen ovale
  • Benign tumors make up 77% of primary cardiac tumors
  • Pericardial tumors are more common than intracardiac tumors

Pericardial tumors are more common than intracardiac tumors

  • Primary sites: lung, breast and melanoma
  • May be multiple
  • Commonly enhance
  • Primary may be seen on the scan

Lymphoma Involves the Pericardium

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Left Innominate Vein Encased

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Pericardial Hemorrage

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Constrictive Pericarditis

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© 1999-2019 Elliot K. Fishman, MD, FACR. All rights reserved.