CTICasesLeft Atrial Thrombus mimicking Sarcoma
Imaging findings
CT angiography demonstrates a lobular, hypodense filling defect in the left atrium extending into the right superior pulmonary vein ostium. On delayed imaging, the defect completely fills in, confirming slow flow/thrombus rather than a vascular tumor.
Key takeaways
Slow blood flow in the left atrium or pulmonary vein ostia (particularly post-ablation) can cause transient filling defects on early gated CT that mimic a thrombus or sarcoma. Delayed phase imaging is essential to demonstrate complete contrast mixing and avoid misinterpretation.
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