CTICasesDiffuse Large B-Cell Lymphoma Mimicking Post-Ablation Hematoma
Imaging findings
CT scan demonstrates a large, soft-tissue mass surrounding the descending thoracic aorta, which developed approximately four weeks following a catheter ablation procedure for atrial fibrillation and was initially interpreted as an organizing peri-aortic hematoma. Subsequent FDG-PET/CT scan shows intense metabolic activity within this mass as well as hypermetabolic cervical lymphadenopathy, which was biopsied to yield a diagnosis of diffuse large B-cell lymphoma (DLBCL).
Key takeaways
While new mediastinal soft tissue collections following cardiac ablation procedures are frequently inflammatory or hematogenous in origin, radiologists must remain vigilant for concurrent, unrelated pathology. This case represents a classic illustration of Hickam's dictum—that a patient can have as many diseases as they please—and highlights the utility of PET/CT and biopsy in atypical post-procedural collections.
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