Large pericardial effusion

Case contributed by Dr Balint Botz

Presentation

Known metastatic squamous cell carcinoma of the lung. Worsening dyspnea.

Patient Data

Age: 65 years
Gender: Male
X-ray

Grossyl enlarged cardiac shadow demonstrating the water bottle sign, bilateral pleural effusion, multiple intrapulmonary masses. Enlarged pulmonary vasculature, diffuse, inhomogenously increased interstitial markings.

Ultrasound

Ultrasound confirmed pericardial effusion with a mean thickness of approximately 30 mm, indicating a significant buildup of fluid in the pericardial sac (>20 mm: >500 ml)

Case Discussion

Echocardiograhy and subsequently pericardiocentesis was performed, 1200 ml of fluid was aspirated from the pericardial sac, which was proved to be malignant by cytology.

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