CTICasesMalignant Pericardial Effusion
Imaging findings
Chest CT demonstrates a large pericardial effusion associated with smooth, circumferential pericardial thickening and intense enhancement, mimicking a benign infectious pericarditis. There is moderate ascites and a right pleural effusion. Tapping the pericardial and peritoneal fluids reveals metastatic adenocarcinoma of the lung, despite the lack of a dominant primary lung mass on CT.
Key takeaways
Malignant pericardial effusions typically present with nodular or irregular pericardial thickening. However, they can occasionally present with smooth, uniform thickening that mimics benign, viral, or tuberculous pericarditis. Pericardial fluid cytology is diagnostic, and a thorough search for a primary malignancy (such as lung adenocarcinoma) is required.
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